The goal of this clinical trial is to compare open carpal tunnel release using local anesthesia with or without a tourniquet. The main questions it aims to answer are:

1. Do the tourniquet cause more procedural pain?
2. Does the use of tourniquet affect the outcome after the procedure? Participants will be randomized to either local anesthesia with a tourniquet or local anesthesia with adrenaline, and undrgo standard open carpal tunnel release.

Inclusion Criteria:

• Primary idiopathic CTS
• Age 18 or older
• Symptoms of classic or probable carpal tunnel syndrome according to Katz hand diagram
• No previous wide awake hand surgical procedures under local anesthesia
• No planned concomitant procedures

Exclusion Criteria:

• Recurrent carpal tunnel syndrome
• Vibration induced neuropathy
• Polyneuropathy
• Cognitive impairment
• Anxiety disorder
• Swedish language insufficiency
• Active substance abuse
• Allergy to local anesthesia or adrenaline
• Patient refusal to participate