Introduction Wide awake open carpal tunnel
decompression is a procedure performed under
local anesthesia. This study aimed to present the effect of various
local anesthetics in peri and postoperative
analgesia in patients undergoing this procedure. Materials and Methods A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under
local anesthesia. Patients were divided in five groups according to
local anesthetic administered:
lidocaine 2%,
ropivacaine 0.75%,
ropivacaine 0.375%,
chirocaine 0.5%, and
chirocaine 0.25%. Total 400 mg of
gabapentin were administered to a subgroup of 10 cases from each group (50 cases totally), 12 hours before surgery. Patients were evaluated immediately, 2 weeks and 2 months after surgery according to VAS
pain score, grip strength, and two-point discrimination. Results In all patients,
pain and
paresthesia improved significantly postoperatively, while the use of
gabapentin did not affect outcomes. Grip strength recovered and exceeded the preoperative value 2 months after surgery, without any difference between the groups. No case of
infection,
hematoma, or
revision surgery was reported. Conclusion Recovery after open carpal tunnel release appears to be irrelevant of the type of
local anesthetic used during the procedure. Solutions of low
local anesthetic concentration (
lidocaine 2%,
ropivacaine 0.375%, and
chirocaine 0.25%) provide adequate intraoperative
analgesia without affecting the postoperative course.