

Background and Goal of Study: Carpal tunnel surgery in the Netherlands can be performed with or without an anesthesiologist attending. For procedures with a long tourniquet time, where comorbidities of the patient require more accurate monitoring, or when the patient is refusing to have the operation without some sort of sedation, the attendance of an anesthesiologist is necessary. An interest in the various approaches to provide anesthesia for this procedure, the role of the brachial plexus block (BPB), and the current standard of anesthetic practice in carpal tunnel surgery in the Netherlands triggered this study.

 

Materials and Methods: The study was approved by the Institutional Review Board. An electronic survey questionnaire containing 9 questions was distributed through the electronic newsletters of the Dutch Society of Anesthesiology and the Dutch Association for Regional Anesthesia. Information was requested regarding the current anesthetic practice for carpal tunnel surgery with particular attention to frequency and type of anesthesia, together with technical aspects. Data were collected using Google forms software. Participation was anonymous and voluntary and dependent on clicking on the link displayed in the newsletter.

 

Results and Discussion: Responses were received from anesthesiologists working in 38 different clinics, representative of approximately 43% of official Dutch hospital organizations.

Carpal tunnel surgery is done in the main operating complex in 60.3% of clinics. An anesthesiologist is involved in 84% of cases for providing some form of anesthesia, which is found to be a BPB in 52% of cases. The preferred approach to the BPB is the axillary approach. We found that 76% of our respondents used 25ml or less of local anesthetics. Ultrasound guidance is used alone or in combination with neurostimulator guidance in 77.6%.  

 

Conclusions: In more than half of the clinics studied, carpal tunnel surgery is done in the main operating room, with the BPB being the most performed anesthesia technique. This study gives insight in the current anesthetic practice for carpal tunnel surgery nationwide and can be useful in the development of future guidelines. 

02 / Anesthesia techniques for Carpal Tunnel Syndrome Surgery in the Netherlands