Axillary Block or Wide-awake Local Anesthesia for Complex Regional Pain Syndrome (CRPS) Following Common Hand Surgeries

Comparison of Axillary Block Regional Anesthesia and Wide-awake Local Anesthesia No Tourniquet (WALANT) Anesthesia in the Incidence of Complex Regional Pain Syndrome (CRPS) Following Common Hand Surgeries

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).

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.

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