gms | German Medical Science

Objectives/Interrogation: Carpal tunnel syndrome (CTS), is the most common of the peripheral nerve compression syndromes of the upper extremity. Generally, patients have bilateral symptoms. The counterpoint of the need for an earlier return to both daily and professional routine work associated with new outpatient anesthetic techniques has led to studies for the simultaneous decompression of the carpal canal, Such assumptions underscore the importance of decision making in relation to the patient with bilateral symptoms and surgical necessity. In order to perform surgery on an ambulatory level, either in one or both upper limbs, without the need for tourniquet and sedation, the local anesthesia technique with lidocaine and epinephrine combination has been shown to be a good option. Thus, the proposal of this study is to compare the functional and satisfaction results of the median nerve release simultaneously and in two stages in patients with bilateral carpal tunnel syndrome and in these, to verify the feasibility of the local anesthesia technique with the use of lidocaine associated with epinephrine

Methods: This is a prospective study with data analysis (DASH, functional quality of life, return to activities, ENMG and patient satisfaction) of 106 patients. Divided into two groups, group I underwent bilateral surgery simultaneously and group II underwent two-step surgical procedure using local anesthesia proposed in both groups.

Results and Conclusions: DASH from preoperative to postoperative showed improvement in both groups, with a greater variation in group I from 27.1 to 10.1. The return to daily activities of group I was 7.39 days and the mean of the two values in group II was 5.66 and the sum was 11, 31. The return to practical activities was 19.12 days in group I, the mean in group II was 23.95 and the sum of 47.91. Minimal bleeding was observed after the skin incision and dissection in 86.3% without compromising the surgical field. In 2 cases, anesthesia was required. Conclusion: bilateral nerve release performed simultaneously and in two stages presents good results, with significant improvement of the DASH and the time of return to the work activities in cases operated simultaneously. The local anesthesia technique with lidocaine and epinephrine is safe and effective.