Comparison of Local versus General Anaesthesia for Carpal Tunnel Release

Research Article

Austin J Musculoskelet Disord. 2017; 4(2): 1043.

Comparison of Local versus General Anaesthesia for Carpal Tunnel Release

Karaca S¹*, Akpolat AO¹, Oztermeli A¹, Bildik C¹, Erdem MN² and Saygi B¹

1Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Training and Research Hospital, Turkey

2Department of Orthopaedics and Traumatology, Hisar Intercontinental Hospital, İstanbul, Turkey

*Corresponding author: Sinan Karaca, Fatih Sultan Mehmet Training and Research Hospital, Orthopaedics and Traumatology Clinic, 34856 Ataşehir/İstanbul, Turkey

Received: December 11, 2016; Accepted: March 09, 2017; Published: March 15, 2017


Purpose: Our aim was to compare the clinical results of patients had carpal tunnel release surgery under local anesthesia and general anesthesia.

Methods: We studied visual analogue scores and visual analogue patient satisfaction scores of 148 patients who underwent carpal tunnel release surgery. 100 patients who met the inclusion criteria were included in this study. There were 12 males 38 females in general anesthesia group and 15 males 35 females in local anesthesia group. The mean age in general anesthesia group was 51.4 (31-78) and in local anesthesia group was 54.4 (28-81).

Results: Visual analogue scores in general anesthesia group was 7.9 and decreased 2.9 postoperatively in local anesthesia group visual analogue score was 8.0 and decreased 2.9 postoperatively (p > 0.05). Visual analogue patient satisfaction score was 7.6 in general anesthesia group and 7.9 in local anesthesia group (p > 0.05).

Conclusion: A high percentage of patients reported high levels of satisfaction, excellent results and improvements in their quality of life in both group. As the VAS and VAPSS were considered the primary outcome measure, the results of our study show that the type of anaesthesia has no effect on the results of surgical treatment of CTS. There were no significant differences in clinical results between 2 groups.

Keywords: Carpal tunnel syndrome; Open surgery; Carpal tunnel release; Local anesthesia; General anesthesia


Carpal tunnel syndrome (CTS) is a common neuropathy, affecting the median nerve as it passes under the transverse carpal ligament [1]. CTS is described as a nerve compression at the wrist plane, CTS causes numbness and tingling in the hand and fingers. Sir James Paget defined CTS first in1853, and since then, in the 1950s a scientist named George Phalen popularized the diagnosis and treatment of CTS [2-4]. The aetiology of CTS is considered idiopathic in most cases but it is still controversial [5,6].

Conservative treatment consists of splinting or corticosteroid injections and surgical release of the carpal tunnel are the treatment method options [7-9]. There has been continued debate over the optimal management of this disease. Decision of the surgeon has consistently varied [10,11].

Carpal tunnel release (CTR) is known as an effective treatment for idiopathic CTS. CTR is performed with a variety of techniques such as endoscopic (ECTR) or open (OCTR). Literature has not got consensus on the superiority of any one technique to another [10-12].

Local anaesthesia (LA) and general anaesthesia (GA) are anaesthetic options on the surgical treatment of CTS. LA is safe, fast, and effective, but the injection could be painful [13,14]. In one recent series, about 10% of patients indicated that they would prefer another form of anaesthesia [15]. When applying the local anaesthetics under the skin patient could have pain and pain could make the patient uncomfortable. Also from the surgeon side discomfort of the patient could affect the surgical procedure and sometimes visualization of the surgical area could be difficult due to oedema caused by local anaesthetics. These problems in surgical procedure could affect the clinical results of the surgery. Sedation or GA could make the procedure more comfortable [16].

The aim of the present study was to compare the effects of the anaesthetic methods on the patient’s clinical results. To our knowledge this is the first report that compares the clinical outcomes of the open CTR with GA or LA.

Materials and Methods

Computerized patient database was searched to identify all patients with CTS who underwent open CTR between January 2009 and January 2013 at Fatih Sultan Mehmet Training and Research Hospital. The year 2013 was selected to ensure a minimum one-year follow-up. At the result of the search total of 148 patients (169 CTS hands) were found.

Of the 148 patients (169 CTS hands) 21 patients were operated bilaterally and excluded from study. Of the 127 patient operated monolaterally. One patient died from another reason and 14 patients was not available and excluded from the study. Fifty five patients operated with GA (group A) and 57 patients with LA (group B). The last available 50 monolateral patient operated by the same surgeon for each group included to the study (Figure 1).