Improvements in Sleep and Pain After Carpal Tunnel Release Surgery
Steven R Niedermeier, MD; Hisham M. Awan, MD
Hand & Upper Extremity Center, Ohio State University, Columbus, OH
Purpose: Nearly half of a million carpal tunnel release (CTR) procedures performed per year. Nighttime symptoms have been a well-documented sequelae of carpal tunnel syndrome (CTS) including pain and paresthesias that wake a patient up at night requiring bracing. Additionally, pain and decreased function are common complaints in this population and there are some who rely on narcotic pain medication to assuage the severity of symptoms. The aim of this study is to show objective improvement in sleep, narcotic use, and pain scores after CTR.
Methods: With IRB approval, all patients scheduled to undergo CTR for electromyographically proven CTS were solicited to participate in this study. Preoperatively, patients filled out Pittsburgh Sleep Quality Assessments (PSQI), Visual Analog Scale (VAS), and Disabilities of Arm, Shoulder, and Hand. These patients were seen at two and six weeks post-operatively and given those same tests in addition to answering questions regarding narcotic use and specific symptom relief.
Results: A total of 61 patients were enrolled. Average DASH scores improved from 51 pre-operatively to 38.7 and 24.5 at two and six weeks after CTR (p < 0.05). Average VAS scores improved from 6.7 to 3.5 and 2.9 at two and six weeks (p < 0.05). And average PSQI scores also improved from 10.4 to 7.8 and 6.4 at two and six weeks post-operatively (p <0.05). Patient stated at six-week follow-up that they had improved sleep on average 2.9 days after CTR. Nearly 80% of patients were off all narcotic pain medication less than three days post-operatively.
Conclusion: Patients had profound improvements in objective pain and sleep scores at both two and six week time points. Patients also endorsed subjective improvements in sleep and overall symptoms and the majority of them only requiring narcotic pain medication for the first few days after surgery.
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