Questioning the use of tourniquets in carpal tunnel surgery and determining ideal level

Our aim was to determine if tourniquet use was a requirement in CTS release surgery, by evaluating patients in which tourniquets were used at different levels and patients in which tourniquets were not used during surgery. A total of 48 patients were included in the study. Eighteen patients had bilateral carpal tunnel syndrome. In these patients, the surgery of one side was performed with a forearm tourniquet, while the other side was performed with the conventional upper arm tourniquet. Thirty patients underwent carpal tunnel release surgery without a tourniquet. The duration of surgery, heart rate, blood pressure, pain status (visual analogue scale) of all patients, and the blood loss of patients who underwent surgery without a tourniquet were recorded. When the tourniquet and no-tourniquet groups were compared, there were no significant differences in terms of pain and physiological response. However, patient satisfaction was higher in the no-tourniquet group while operation times were longer. We believe that the local anesthetic + epinephrine without tourniquet method is advantageous compared to the other methods

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1. Kerwin G, Williams CS, Seiler JG 3rd. The pathophysiology of carpal tunnel syndrome. Hand Clin. 1996;12(2):243–51.

2. Koris M, Gelberman RH, Duncan K, Boublick M, Smith B. Carpal tunnel syndrome. Evaluation of a quantitative provocational diagnostic test. Clin Orthop Relat Res. 1990 ;251:157-61.

3. Tzarnas CD Carpal tunnel release without a tourniquet. J Hand Surg Am. 1993 ;18(6):1041-3.

4. Mense S, Gerwin RD. Muscle pain: understanding the mechanisms. Springer Verlag, Berlin-Heidelberg. 2010:77–8.

5. Jai Prakash Sharma, Rashmi Salhotra. Tourniquets in orthopedic surgery. Indian J Orthop. 2012;46(4): 377–83.

6. Micheal K. Urban. Anaesthesia for orthopaedic surgery. In: Miller RD, Miller’s Anesthesia 7th edition. Churcill Livingstone Publishers, Philadelphia, 2010; 2252.

7. Kutty S, McElwain JP. Padding under tourniquets in tourniquet controlled surgery: Bruner’s ten rules revisited. Injury. 2002;33:75.

8. Cousins GR, Gill SL, Tinning CG, Johnson SM, Rickhuss PKJ. Arm versus forearm tourniquet for carpal tunnel decompression - Which is better? A randomized controlled trial. Hand Surg Eur. 2015;40(9):961-5.

9. Maury AC, Roy WS. A prospective, randomized, controlled trial of forearm versus upper arm tourniquet tolerance. J Hand Surg (Br). 2002;27(4):359–60.

10. Glynn A, Strunk S, Reidy D, Hynes DE. Carpal tunnel release using local anaesthetic and a forearm tourniquet. Ir Med J. 2005;98(5):144-5.

11. Odinsson A, Finsen V. The position of the tourniquet on the upper limb. J Bone Joint Surg Br. 2002;84(2):202-4.

12. Kamal Nagpal, Mohammed Gossiel, Hari Kumar. The impact of tourniquet on patient satisfaction in Carpal tunnel decompression. CEJMed. 2007;2(2):222-6.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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