There are two anesthesia options for patients undergoing carpal tunnel release. The first option is local anesthesia, which is the same type of anesthesia you may have received at the dentist's office. The second option is monitored anesthesia care, which is also known as "twilight sleep", and is commonly administered during a colonoscopy. Almost all my patients choose local anesthesia.
With local anesthesia, numbing medication is injected at the site of surgery. The numbing medications can provide from 1 to 24 hours of pain relief, depending on the specific medication used. The muscles controlled by the numbed nerves may also be weak until the medication wears off. This is a great option for patients who do not want to be sedated. Even though you will be wide awake, you will not be able to see the surgery itself because a large sterile drape will be blocking your view.
Patients who choose local anesthesia enjoy the benefits of being able to eat and drink up to the time of surgery. There are no effects of drowsiness or nausea after surgery performed under local anesthesia. In addition, local anesthesia eliminates the need for a companion before, during, or after surgery. Patients are able to drive themselves to and from the surgical center. The wait in the recovery room is about 5 minutes before release. For more detailed information, see Wide Awake Hand Surgery.
Monitored Anesthesia Care (MAC)
Monitored anesthesia care or MAC is a type of sedation that is administered through an IV. The degree of sedation can vary from light to heavy. With light sedation, the patient feels very relaxed, while with heavy sedation, he or she is not aware of the surroundings or the procedure being performed. The patient's vital signs are continuously monitored by an anesthesiologist who also maintains and adjusts the level of sedation as needed. Patients having MAC may not eat or drink anything after midnight before surgery. They must have a driver to and from the surgery center who will also be required to monitor the patient for the next 24 hours. The wait in the recovery room is 1-2 hours before release.
Are There Any Complications?
There are associated risks with any type of anesthesia. These include incomplete pain relief, soreness or bruising at the needle site, or tingling that lasts for several days. Serious complications such as significant bleeding, infection, or nerve injury are very rare. Your anesthesiologist and I will check to make sure you are comfortable before, during, and after the procedure.