Carpal Tunnel Syndrome
Conditions
Brief summary
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the upper extremity. While carpal tunnel release (CTR), both open (OCTR) and endoscopic (ECTR), is safe and effective, there are questions regarding the use of postoperative dressings after surgery. It is not currently known if dressing choices influence post-operative pain, function or patient satisfaction after ECTR. A less cumbersome dressing (bandaid) may allow patients to perform daily tasks with more ease after surgery. The purpose of this investigation is to compare postoperative pain scores and patient satisfaction after ECTR for patients treated with conventional post-operative bulky soft tissue dressings versus those treated with a bandaid after surgery. The hypothesis is that patients using a bandaid after surgery will have an easier time with functional tasks after surgery and that pain scores will not significantly differ between the two groups. Furthermore, this study aims to determine if there are differences in patient satisfaction, functional outcomes, complications, and unscheduled healthcare contact between these two groups. This will be a randomized, controlled investigation.
Detailed description
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the upper extremity. While carpal tunnel release (CTR), both open (OCTR) and endoscopic (ECTR), is safe and effective, there are questions regarding the use of postoperative dressings after surgery. With recent attention to the opioid epidemic, there have been increasing efforts to reduce narcotic usage postoperatively while still controlling expected postoperative pain. Recent authors have found that many patients, particularly older patients, do not require any opioid analgesia after CTR with 47% of men and 36% of women consuming no narcotics after CTR (CHAPMAN). Furthermore, while splints have historically been used after surgery, their need has recently been questioned (LOGLI). It is not currently known if dressing choices influence post-operative pain, function or patient satisfaction after ECTR. A less cumbersome dressing (bandaid) may allow patients to perform daily tasks with more ease after surgery. The purpose of this investigation is to compare postoperative pain scores and patient satisfaction after ECTR for patients treated with conventional post-operative bulky soft tissue dressings versus those treated with a bandaid after surgery. The hypothesis is that patients using a bandaid after surgery will have an easier time with functional tasks after surgery and that pain scores will not significantly differ between the two groups. Furthermore, this study aims to determine if there are differences in patient satisfaction, functional outcomes, complications, and unscheduled healthcare contact between these two groups. This will be a randomized, controlled investigation.
Interventions
OTHERBandaid
Bandaid dressing
OTHERConventional bulky soft tissue dressing
Conventional bulky soft tissue dressing
Sponsors
Chris Grandizio
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients 18 years of age or older 2. Patients undergoing primary, elective, unilateral ECTR under monitored anesthesia care with local anesthesia.
Exclusion criteria
1. Patients undergoing ECTR as part of a worker's compensation case 2. Patients currently incarcerated 3. Subject who cannot read and speak English
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale Pain Score | 0-12 months | best 0-10 worst; continuous scale to measure current pain level |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PROMIS Pain Interference | 0-12 months | best 0-100 worst; measures the effects of a patient's pain on their daily activities and lifestyle |
| PROMIS Self-Efficacy Manage Symptoms | 0-12 months | best 0-100 worst; measures a patient's ability to cope with their symptoms related to the procedure |
| PROMIS Upper Extremity | 0-12 months | worst 0-100 best; measures physical function of upper extremities |
| QuickDASH | 0-12 months | best 0-100 worst; functional outcome score for disabilities of the arm, shoulder, and hand |
| number of participants with unscheduled healthcare contact | 0-12 months | unscheduled healthcare contact includes patient calls/messages, emergency room visits, or scheduled clinic visits |
| Boston Carpal Tunnel Questionnaire | 0-12 months | ranges from 1 to 5, with a higher score indicating greater disability; -specific measure of self-reported symptom severity and functional status |
| number of participants with complications | 0-12 months | complications after surgery including infection and delayed healing |
| Satisfaction with overall outcome | 0-12 months | 11 point Likert scale; worst 0-10 best |
| Satisfaction postoperative pain control | 0-12 months | 11 point Likert scale; worst 0-10 best |
| Satisfaction with the dressing | 0-12 months | 11 point Likert scale; worst 0-10 best |
| Grip Strength Measurement | 0-12 months | Using Jamar Hand Dynamometer, in kilograms ranging from worst 0-90 best |
| morphine equivalents | 0-12 months | morphine equivalents consumed for post-operative pain control |
Outcome results
None listed