Orthopaedic Department of Hippokration General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece.
Int Orthop. 2013 Aug;37(8):1501-5. doi: 10.1007/s00264-013-1951-0. Epub 2013 Jun 9.
The purpose of this study was to evaluate whether simultaneous bilateral endoscopic carpal tunnel release could be effectively and safely performed under local anaesthesia.
We prospectively evaluated 85 consecutive patients (62 females) who underwent simultaneous one portal endoscopic bilateral carpal tunnel release with subcutaneous injection of 2 mL 2 % lidocaine. In case of pain after discharge, all patients were advised to take paracetamol (i.e., acetaminophen) and to record the dose of drug taken. Patients were reviewed at regular intervals until one year postoperatively.
The mean operative time was 31.2 min. Postoperatively, only nine patients (10.6 %) received on average 611 mg of paracetamol. Significant improvement was noticed in the parameters of numbness, pain, positive Phalen and Tinel tests, pinch strength, grip strength, tip pinch strength and Quick DASH Score. Patients returned fully to work after surgery in average 2.2 weeks. Conversion to open release took place in four wrists (2.4 %). Discomfort and pain from tourniquet pressure was reported from two patients (2.4 %). Two wrists (1.2 %) required revision surgery. One patient (1.2 %) reported temporary thenar numbness and another (1.2 %) had slight scar hypersensitivity.
Simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia is well tolerated by patients. The technique may be of benefit in young, active, high-demand patients who require fast recovery, early return to work and less disability time.
本研究旨在评估在局部麻醉下同时进行双侧内窥镜腕管松解术是否可行且安全。
我们前瞻性评估了 85 例连续患者（62 名女性），他们接受了 2ml 2%利多卡因皮下注射的同时进行单侧内窥镜双侧腕管松解术。出院后如出现疼痛，所有患者均被建议服用扑热息痛（即对乙酰氨基酚），并记录服用药物的剂量。患者定期接受随访，直至术后 1 年。
平均手术时间为 31.2 分钟。术后，只有 9 名患者（10.6%）平均服用了 611 毫克扑热息痛。麻木、疼痛、Phalen 和 Tinel 试验阳性、捏力、握力、指尖捏力和 Quick DASH 评分等参数均有显著改善。患者术后平均 2.2 周即可完全恢复工作。有 4 例（2.4%）转为开放性松解。2 例（2.4%）患者报告因止血带压力引起不适和疼痛。有 2 例（1.2%）手腕需要再次手术。1 例（1.2%）患者报告短暂性鱼际麻木，另 1 例（1.2%）有轻微疤痕过敏。
局部麻醉下同时进行双侧内窥镜腕管松解术患者耐受性良好。对于需要快速恢复、早日重返工作岗位和减少残疾时间的年轻、活跃、高需求患者，该技术可能有益。
