Surgery for carpal tunnel syndrome under antiplatelet therapy.
OBJECTIVE
Antiplatelet therapy is often instituted after cardiovascular or neurological ischemic events. In general, discontinuation of the antiplatelet medication for several days is warranted previous to surgery. However, discontinuation can lead to ischemic events. For some forms of surgery, the risks of an ischemic event, and especially, its consequences do not outweigh the benefit of discontinuation of the antiplatelet therapy. Retrospective analysis was done of a cohort of patients treated for carpal tunnel syndrome with special emphasis on postoperative hemorrhage in combination with antiplatelet medication.


METHODS
Retrospective analysis of cohort consisting of 362 consecutive patients treated for carpal tunnel syndrome in the Neurosurgical Centre, Nijmegen was done.


RESULTS
In 362 patients 423 operations on carpal tunnel release were done. Thirty-one patients were on antiplatelet therapy, of which 6 did not discontinue the medication before surgery. The remaining patients stopped at least seven days before surgery. A postoperative hemorrhage did not occur in any of the 423 operations.


CONCLUSIONS
There seems no reasonable evidence that discontinuation of aspirin for carpal tunnel syndrome is justified. Bleeding complications are considered rare, moreover the impact of an ischemic cardiovascular or a cerebral event would be far more severe than that of postoperative hemorrhage in the wrist.
Boogaarts
Hieronymus D
HD
Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Reinier Postlaan 4, 6500 HB Nijmegen, The Netherlands. H.Boogaarts@nch.umcn.nl
Verbeek
André L M
AL
Bartels
Ronald H M A
RH
D000772:Anesthesia, Local; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D002349:Carpal Tunnel Syndrome / Q000150:complications* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin