Single-center experience of cubital tunnel syndrome surgery performing transposition or internal neurolysis with external decompression under regional intravenous anesthesia technique

Authors : Ali Güler

Pages : 438-444

Doi:10.38053/acmj.1344313

View : 63 | Download : 93

Publication Date : 2023-10-27

Article Type : Research Paper

Abstract :Aims: To share the 7-year experience of a single center in the application of regional intravenous anesthesia (RIVA) for surgical treatment of cubital tunnel syndrome (CTS) caused by compression of the ulnar nerve in the elbow region. Methods: A total of 100 patients with CTS who were operated with the RIVA technique at a single center between 2012 and 2019 were retrospectively analyzed. In the RIVA technique, after providing venous drainage in the operated side arm, the double cuff tourniquet was inflated in the upper arm, and anesthesia was provided by administering a 30-40 mL solution of 2% lidocaine (3 mg/kg) diluted in 1% saline through the intravenous catheter. The surgical methods applied (transposition or internal neurolysis with external decompression), demographic data, preoperative and postoperative visual analog scale (VAS) scores for pain were compared. Results: Out of 100 patients, 30 patients underwent surgical transposition (group 1) while internal neurolysis with external decompression was performed in 70 patients (group 2). The mean age of patients in groups 1 and 2 was 66.3±12.1 and 60.6±11.7 years, respectively. Women accounted for 73.3% of patients in group 1 and 87.1% of patients in group 2. The left side was affected in 18 (60%) patients in group 1 and 42 (60%) patients in group 2. In group 1, the mean postoperative 3rd-week VAS score (1.96±0.76) was significantly lower than the mean preoperative VAS score (7.46±0.93; p<0.001). Similarly, in group 2, the mean postoperative 3rd-week VAS score (1.84±0.62) was significantly lower than the mean preoperative VAS score (7.45±0.87; p<0.001). There was no significant between-group difference with respect to preoperative or postoperative 3rd-week VAS scores. Conclusion: In the presence of technical infrastructure, the RIVA method can be preferred in the surgical treatment of CTS.
Keywords : Ulnar sinir, dekompresyon, RİVA, VAS