Effect of Epinephrine With Local Anesthesia Used in Carpal Tunnel Release on Operative Time, Surgical Site Infection, and Postoperative Pain
DOI:
https://doi.org/10.31149/ijimm.v3i6.2990Keywords:
carpal tunnel syndrome, carpal tunnel release, LIAWE, epinephrine, local infiltrative anesthesia with no tourniquetAbstract
Epinephrine is the basis for local infiltrative anesthesia without tourniquet (LIAWE), which creates a comparatively bloodless area. This research sought to ascertain if epinephrine had any impact on bleeding or surgical time during carpal tunnel release (CTR) procedures, including whether electrocautery or a tourniquet were required. It was postulated that local anesthesia, devoid of epinephrine, is a safe substitute for CTA and extends the duration of surgery. Analysis was done on every patient who had CTR under local infiltrative anesthesia between December 2022 and June 2024. 5 cc of 2% lidocaine (local infiltrative anesthesia, no epinephrine [LIANE] group) or 5 cc of 2% lidocaine with 1:100,000 epinephrine (8.4%) (LIAWE group). It was determined how long it took for the skin to close after the incision. Information about the use of tourniquets, electrocautery, and surgical complications was documented. Of the 64 patients who had CTRs, 30 were done under LIANE and 34 under LIAWE. The skin-skin time was 8.6 minutes (6–14 minutes, standard deviation [SD] =3.3) for LIAWE and 14.5 minutes (9–26 minutes, SD =3.5) for LIANE. The skin-skin time difference between the two groups was 40%, which was a significant difference. Six hours after surgery, there was a noticeable difference in discomfort between the two groups. No tourniquet was employed, and no patients required electrocautery. No complications occurred during the procedure. Without epinephrine, the procedure took 40% longer. While widespread awake anesthesia does not need epinephrine, it does have the extra benefit of reducing surgical time.
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