Axillary Block, CRPS, Walant
Conditions
Keywords
CRPS, flare reaction, WALANT, axillary block
Brief summary
Flare reaction, characterized by excessive erythema, stiffness, and edema postoperatively, can lead to complex regional pain syndrome (CRPS) when pain is present. This study compares flare and CRPS incidence following hand surgeries performed under regional anesthesia with axillary block (RAAB) and WALANT (Wide-Awake Local Anesthesia No Tourniquet).
Detailed description
This two-center prospective study included patients undergoing Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), and trigger finger (TF) surgeries under RAAB or WALANT. Diagnostic criteria for flare and CRPS (pain, weakness, scar issues, erythema, and swelling) were assessed, and comorbidities were noted. The incidence of flare reactions and CRPS was compared for RAAB and WALANT.
Interventions
PROCEDURESurgery for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF)
All of the patients were operated for Dupuytren contracture (DC), DeQuervain tenosynovitis (DQS), carpal tunnel syndrome (CTS), or trigger finger (TF). The study is two center study, one center has the routine of RAAB (regional anesthesia with axillary block) and the other has the routine of WALANT (wide awake local anesthesia no tourniquet) for the mentioned surgeries.
PROCEDURERegional Anesthesia
Regional anesthesia with axillary block
PROCEDURELocal Anesthesia
Wide awake local anesthesia no tourniquet
Sponsors
Ankara University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with and operated on for Dupuytren contracture (DC), * Patients diagnosed with and operated on for De Quervain tenosynovitis (DQS), * Patients diagnosed with and operated on for carpal tunnel syndrome (CTS), * Patients diagnosed with and operated on for trigger finger (TF)
Exclusion criteria
* Patients operated under general anesthesia, * Patients operated with other types of regional anesthesia (eg: supraclavicular block), * Patients operated with other types of local anesthesia (only prilocaine or bupivacaine) * Patients less than 3 months follow up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CRPS severity score (CSS) | Postoperative first month | CRPS: Complex regional pain sydrome The CRPS Severity Score is a composite measure derived from multiple clinical findings, summed to provide a single score ranging from 0 to 16. The ccore is based on four major clinical domains, with each domain contributing 0 to 4 points, leading to a total possible score of 16 points. 1. Sensory Symptoms (0-4 points) Allodynia (Pain due to a stimulus that does not normally provoke pain) Hyperalgesia (Increased pain response to a normally painful stimulus) 2. Vasomotor Symptoms (0-4 points) Temperature asymmetry (≥1°C difference between affected and unaffected limb) Skin color changes (Mottled, red, cyanotic, or pale discoloration) 3. Sudomotor / Edema Symptoms (0-4 points) Abnormal sweating (Hyperhidrosis or hypohidrosis) Edema (Swelling) in the affected area 4. Motor / Trophic Symptoms (0-4 points) Motor dysfunction (Weakness, dystonia, tremors) Trophic changes (Altered nail growth, skin texture changes, or abnormal hair growth) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Flare reaction | Postoperative first month | Presence of Flare reaction. Evaluation based on Evans' criteria 0 - no reaction 1. redness, stiffness, edema at the operation site 2. symptoms beyond operation site |
Countries
Turkey (Türkiye)
Outcome results
None listed