Anesthesia for Carpal Tunnel Surgery

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, also known as “twilight sleep” and commonly administered during a colonoscopy.  Almost all my patients choose local anesthesia.  

Local Anesthesia

With local anesthesia, numbing medication is injected at the site of surgery. The numbing medications can provide pain relief from 1 to 24 hours, depending on the specific medication used. The muscles controlled by the numbed nerves may also weaken until the medication wears off. This is an excellent 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 can 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.

On the other hand, wide-awake hand surgery involves injection(s) of a local anesthetic at the surgery site. The local anesthetic can provide 1 to 24 hours of pain relief, depending on the specific medication used. The muscles controlled by the numbed nerves may also weaken until the medication wears off. 

Monitored Anesthesia Care (MAC)

The only time you will feel discomfort is while the local anesthetic is injected. It feels like a bee sting and lasts for a few seconds.

Before your surgery, I will ensure that you are appropriately numb and don’t feel any pain at the surgical site. This is done by pinching an area on your skin that is not numb and comparing the pinching sensation to the area of the skin which has been injected with the local anesthetic. I will not start the procedure until you are completely numb and don’t feel the pinching sensation. You may experience some pressure or a pulling sensation during the procedure, but no pain.  

Are There Any Complications?

There are associated risks with any 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 rare. Your anesthesiologist and I will check to ensure you are comfortable before, during, and after the procedure.