sodium-bicarbonate and Carpal-Tunnel-Syndrome

Open carpal tunnel decompression under local anesthesia is routinely done by many surgeons. However, patients complain of pain during the injection of local anesthesia. This prospective, double-blind, randomized study was to compare the pain visual analog scale (VAS) scores of local anesthesia using lidocaine with and without sodium bicarbonate in patients with bilateral carpal tunnel syndrome.. Twenty-five patients underwent bilateral simultaneous carpal tunnel decompression. All had topical anesthetic cream applied on the palm and wrist before the lidocaine block. In a randomized manner, half of the hands were blocked with nonbuffered lidocaine and half were blocked with buffered lidocaine. Pain was evaluated on a VAS score.. The mean pain VAS score in the hand with buffered lidocaine was 4.6 ± 1.5 and 6.5 ± 1.5 for the hand with nonbuffered lidocaine. After adjustment for individual threshold of the pain, the mean pain VAS score changed into 4.6 ± 1.3 with buffered lidocaine and 6.6 ± 1.7 without buffered lidocaine.. In open carpal tunnel surgery, the use of buffered lidocaine for local anesthesia reduces the anesthetic pain effectively.. Therapeutic I.

Topics: Aged; Aged, 80 and over; Anesthesia, Local; Anesthetics, Local; Buffers; Carpal Tunnel Syndrome; Decompression, Surgical; Double-Blind Method; Female; Humans; Lidocaine; Male; Middle Aged; Nerve Block; Pain Measurement; Prospective Studies; Sodium Bicarbonate

This prospective, randomized study assessed the effectiveness of buffering lidocaine with sodium bicarbonate for reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression. Twenty-one patients undergoing bilateral open carpal tunnel decompression received, in a randomized manner, lidocaine 1% with adrenaline (1:200,000) in one hand and the same local anaesthetic buffered with 8.4% NaHCO3 at a 5:1 ratio in the other hand. Pain, especially its burning element, was evaluated on a visual analogue scale and was significantly reduced with the buffered solution. The buffering was effective for all patients and no adverse effects were noted. This is a safe, easy and quick method for making open carpal tunnel surgery less uncomfortable to patients.

Topics: Adult; Aged; Anesthetics, Local; Buffers; Carpal Tunnel Syndrome; Decompression, Surgical; Double-Blind Method; Drug Combinations; Epinephrine; Female; Humans; Injections, Intradermal; Lidocaine; Male; Middle Aged; Pain; Pain Measurement; Preoperative Care; Prospective Studies; Sodium Bicarbonate; Vasoconstrictor Agents

Topics: Anesthesia, Local; Anesthetics, Local; Anxiety; Buffers; Carpal Tunnel Syndrome; Decompression, Surgical; Humans; Lidocaine; Needles; Pain Measurement; Postoperative Period; Sodium Bicarbonate