title: Should aspirin be stopped before carpal tunnel surgery? A prospective study.
abstract: OBJECTIVE
  To determine whether patients taking aspirin during carpal tunnel release had an increase of complications.
  
  
  METHODS
  Between January 2008 and January 2010, 150 patients underwent standard open carpal tunnel release (CTR) under intravenous regional anaesthesia. They were divided into three groups: groups 1 and 2 were made of 50 patients each, on aspirin 100 mg/d for at least a year. In group 1 the aspirin was never stopped. In group 2 it was stopped at least 5 d before surgery and resumed 3 d after. Group 3 acted as a control, with 50 patients who did not take aspirin. The incidence of clinically significant per- or post-operative complications was recorded and divided into local and cardio-cerebro-vascular complications. Local complications were then divided into minor and major according to Page and Stern. Local haematomas were assessed at 2 d (before resuming aspirin in group 2) and 14 d (after resuming aspirin in group 2) postoperatively. Patients were reviewed at 2, 14 and 90 d after surgery.
  
  
  RESULTS
  There was no significant difference in the incidence of complications in the three groups. A total of 3 complications (2 major and 1 minor) and 27 visible haematomas were recorded. Two major complications were observed respectively in group 1 (non stop aspirin) and in group 3 (never antiaggregated). The minor complication, observed in one patient of group 2 (stop aspirin), consisted of a wound dehiscence, which only led to delayed healing. All haematomas were observed in the first 48 h, no haematoma lasted for more than 2 wk and all resolved spontaneously. A major haematoma (score > 20 cm(2)) was observed in 8 patients. A minor haematoma (score < 20 cm(2)) was recorded in 19 patients. All patients at 90 d after surgery were satisfied with the result in terms of relief of their preoperative symptoms. Major and minor haematomas did not impair hand function or require any specific therapy.
  
  
  CONCLUSIONS
  Our study demonstrates that continuation of aspirin did not increase the risk of complications. It is unnecessary to stop aspirin before CTR with good surgical techniques.
authors.affiliation: Stefania Brunetti, Gianfranco John Petri, Stefano Lucchina, Guido Garavaglia, Cesare Fusetti, Hand Surgery Unit, Department of Orthopaedics and Trauma Surgery, Ospedale Regionale Bellinzona e Valli, 6500 Bellinzona, Switzerland.
authors.forename: Stefania
authors.initials: S
authors.lastname: Brunetti
authors.forename: Gianfranco John
authors.initials: GJ
authors.lastname: Petri
authors.forename: Stefano
authors.initials: S
authors.lastname: Lucchina
authors.forename: Guido
authors.initials: G
authors.lastname: Garavaglia
authors.forename: Cesare
authors.initials: C
authors.lastname: Fusetti
keywords: Antiaggregation therapy; Aspirin; Carpal tunnel release; Carpal tunnel syndrome; Hand surgery