Symptom Outcome of Walant Technique for Carpal Tunnel Release – A Prospective Study in the Tertiary Care Hospital, Nowshera

Abstract

OBJECTIVES The study aims to determine the outcome of the WALANT technique for Carpal Tunnel Release CTR. METHODOLOGY A descriptive study was done in the Neurosurgery department at Qazi Hussain Ahmad Medical Complex, Nowshera, from 15th September 2020 to 15th March 2021. A total of 29 consecutive patients of carpal tunnel syndrome (CTS) were undergoing carpal tunnel release (CTR) under wide awake local anaesthesia no tourniquet (WALANT) technique, using a mixture of lidocaine and epinephrine for local anaesthesia, and the outcome was assessed for patient satisfaction by Boston Carpal Tunnel Questionnaire (BCTQ) (symptom severity scales (SSS)) at pre-operatively and six weeks postoperatively. RESULTS Wide awake CTR was done in 29 patients; 86.2% were female and 13.8% male. The mean age was 47.3 years. The average time of return to daily activity was three weeks. No complications were noted, like wound infection and dehiscence. BCTQ symptom (BCTQ-S) score significantly improved at six weeks postoperatively. 86% significantly reduced the symptom severity score (SSS). Mean SSS improved from preoperative 3.2 points to 1.7 points postoperatively. There was a significant decrease in distal latencies (p <0.01). CONCLUSION Wide awake surgery is an excellent technique with favourable outcomes and good satisfaction rates for CTR. The study shows that clinical symptoms resolve rapidly after CTR. Without the need for monitored anaesthesia, the cost could decrease dramatically.

Keywords

• Wound Infection
• Dehiscence Outcome
• Anaesthesia
• Tourniquet