title: One portal simultaneous bilateral endoscopic carpal tunnel release under local anaesthesia. Do the results justify the effort?
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether simultaneous bilateral endoscopic carpal tunnel release could be effectively and safely performed under local anaesthesia.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Orthopaedic Department of Hippokration General Hospital, 49 Konstantinoupoleos Street, 54642, Thessaloniki, Greece. byronchalidis@gmail.com
authors.forename: Byron E
authors.initials: BE
authors.lastname: Chalidis
authors.forename: Christos G
authors.initials: CG
authors.lastname: Dimitriou
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine