The influence of anaesthesia on CPSP development after carpal tunnel surgery

Abstract

Background: Chronic postsurgical pain (CPSP) is a frequent adverse event after surgery. Although CPSP is much more acknowledged as an important complication in daily clinical practice, its etiology is still not sufficiently explored and demands further investigation. Recent studies revealed the role of the anaesthetic procedure as a possible risk factor of CPSP. The aim of this study was to investigate the influence of anaesthesia on the development of CPSP. Methods: A prospective, multicentric, observational study with a six-month follow-up was carried out. 48 patients completed the study within the study period. Pain intensities were recorded on the first postoperative day and after one, three and six months. After descriptive analysis of the data we took the normal distribution of the data for granted. Accordingly, non-parametric tests like the Mann-Whitney U test, the Chi-square test or the exact test after Fisher were used for statistical analysis. Results: Following carpal tunnel surgery 25% of the patients developed CPSP. 35% of them had general anaesthesia, whereas 17.9% received regional anaesthesia. Significant differences in pain intensity were evidenced. Patients with general anaesthesia reported stronger pain than patients with regional anaesthesia. The pain quality did not differ between the two study groups. Conclusion: Overall results showed an advantage of regional anaesthesia regarding the prevention of CPSP. Patients who underwent general anaesthesia suffered significantly more pain following a carpal tunnel surgery than patients with regional anaesthesia. Patients who had a general anaesthesia suffered from CPSP more often than those who had a regional anaesthesia. The anaesthetic procedure had no influence on the pain quality. However, more, larger and randomized studies are needed to establish the superiority of regional anaesthesia when it comes to preventing CPSP

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