ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 2000 June;44(2):85-8

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Peri- and postoperative pain valutation in carpal tunnel release of median nerve compression

Gunetti R., Bonicalzi V., Riolo C., Pagni C. A.

Neuroscience Department, Neurosurgery Division, University of Turin, Turin, Italy

We ana­lysed 108 ­patients, oper­at­ed on ­day sur­gery, ­for car­pal tun­nel ­release of ­median ­nerve com­pres­sion, to eval­u­ate ­peri- ­and post­op­er­a­tive ­pain. We ­made in ­all cas­es a ­short inter­ten­ar­ian inci­sion (25 mm) ­with micro­sur­gi­cal tech­nique ­and ­local anaesthe­sia ­using mepivacaine 2% with­out vas­o­con­stric­tor. We evaluatedpain ­for ­local anaesthet­ic infil­tra­tion as ­VRS (Verbal Rating Scale) 6,3 ­median-­time to ­the ­first pos­sible anal­ge­sic assump­tion (in ­all cas­es par­a­cet­a­mol 500 mg), ­total anal­ge­sic assump­tion, algom­e­try (to eval­u­ate “allo­diny”) ­after the ­first 48 ­hours ­and sub­jec­tive ­pain inten­sity by a numer­i­cal ­pain scale. Pain inten­sity on ­first ­drug assump­tion (­after a ­mean ­time of 7 ­hours ­from ­the ­end of sur­gery) ­had a ­mean ­VAS val­ue of 2,15; ­while ­after a sec­ond pressure assump­tion of anal­ge­sic (­after a ­mean ­time of 15 ­hours ­from sur­gery) ­had a ­mean ­VAS val­ue of 2. Mean ­total anal­ge­sic assump­tion ­was 1,64 tab­lets of par­a­cet­a­mol 500 mg. From ­these ­data we ­may ­deduce ­that ­peri- ­and post­op­er­a­tive ­pain fol­low­ing ­median ­nerve decom­pres­sion ­with ­this tech­nique ­and anaesthe­sia, ­has a mod­er­ate ­intense ­peak of ­brief dura­tion, ­for ­local anaesthet­ic infil­tra­tion (­that ­seems to be ­the ­most pain­ful ­event) ­and mod­est ­and ­not con­stant ­pain in ­the post­op­er­a­tive ­time (­more evi­dent 7 ­and 15 ­hours ­from ­the ­end of sur­gery). It ­may be use­ful asso­ci­a­tion ­with mepiv­a­caine bicar­bo­nate solu­tions or inject­ing ­less pain­ful ­local anaesthet­ic.