Background
Preemptive analgesia has been used to reduce postsurgery pain and improve patient
satisfaction. The effectiveness of multimodal preemptive analgesia in open carpal
tunnel release under local anesthetic with a tourniquet is still debated. This study
aimed to determine the effectiveness of preemptive analgesia on the postoperative
tourniquet site and the surgical site.
Methods
A total of 44 patients were randomly assigned to one of 2 groups. An experimental
group was given 300 mg of gabapentin, 200 mg of celecoxib, and 500 mg of acetaminophen
2 hours before surgery. Placebos were given to the control group. All surgeries were
done under local anesthetic by a specialist hand surgeon. A tourniquet was inflated
to the recommended pressure. The outcomes included the immediate postoperative tourniquet
site pain scores, surgical site pain scores (at 1, 6, 12, 18, and 24 hours after surgery),
and acetaminophen consumption in the first 48 hours.
Result
The immediate postoperative tourniquet site pain score in the experimental group was
significantly lower than in the placebo group. Although the surgical site pain score
in the experimental group was significantly lower than the placebo group at 1, 6,
12, and 18 hours after surgery, these differences were not clinically significant.
In addition, there was no statistically significant difference in surgical site pain
score at 24 hours after surgery. The amount of acetaminophen consumed during the first
48 hours after surgery was significantly lower in the experimental group than in the
placebo group.
Conclusion
Multimodal preemptive analgesia effectively reduced immediate postoperative pain at
the tourniquet site in open carpal tunnel release. It also reduced postoperative acetaminophen
consumption.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: January 20, 2023
Accepted:
January 14,
2022
Received:
December 28,
2020
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
