gms | German Medical Science

Objective: Ulnar nerve decompression or transposition at the elbow traditionally requires regional or general anesthesia. The purpose of this study was to assess the feasibility and the outcome of performing these procedures under wide-awake local anesthesia without tourniquet and sedation.

Methods: We examined retrospectively the charts of 18 consecutive patients having undergone ulnar nerve entrapment surgery under wide-awake local anesthesia without tourniquet. All the patients were performed in minor operating procedure suites. 12 patients were performed in situ decompression with minimal incision; 4 patients were performed in situ decompression with long incision; 2 patients were performed ulnar nerve anterior subcutaneous transposition. The bleeding and pain during the operation was evaluated. The complications of this procedure were surveyed. After the operation, the patients were asked how patients feel about this procedure.

Results: All the patients had successful decompression of ulnar never under local anesthesia without tourniquet and sedation. During the operation, adequate pain control was reported by all the patients, adequate bleeding control was achieved with no need for a temporary tourniquet. There were no hematoma and infection of incision in the group. All the patients stated that they would choose to have the operation performed under wide-awake local anesthesia without tourniquet again, but one would have favoured general anaesthetic because of anxiety.

Conclusion: Ulnar nerve decompression or transposition at the elbow under wide-awake local anesthesia without tourniquet is a reliable procedure and is well tolerated by the majority of patients.