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Endoscopic Carpal Tunnel Decompression

WHAT YOU NEED TO KNOW:

Endoscopic carpal tunnel decompression is surgery to take pressure off of the median nerve in your wrist. A scope and small tools are put through 1 or 2 small incisions on your wrist or palm. A scope is a thin, flexible tube with a light and camera on the end.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  • Your hand will be placed on a table, cleaned, and covered with a sheet. Your caregiver will give you anesthesia medicine to help decrease the pain during your surgery. You may be given local anesthesia to numb your wrist and hand. You may also get regional anesthesia that numbs your arm or general anesthesia to keep you completely asleep.
    • Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.
    • Intravenous (IV) regional anesthesia: This is medicine put into an IV in the injured arm or leg. A pressure cuff is first put on your arm or leg. After the cuff is tightened, the medicine is put into the IV. The cuff keeps the medicine in the arm or leg so you will not have pain.
    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

  • A cuff called a tourniquet may be put around your upper arm to decrease bleeding during your surgery. Your caregiver will make 1 or 2 incisions on your wrist or palm. He will insert the endoscope with the camera through an incision to help guide him during surgery. Special tools may be put in your wrist to help protect your nerves.
  • He will cut the ligament that is pressing on the nerve. The incision will be closed with stitches and covered with bandages. Your caregiver will then take off the tourniquet.

After your surgery:

A splint will be put on your wrist to keep the wrist from twisting or bending. You will stay in a room until you wake up and gain feeling in your arm. You will be asked to move your fingers soon after your surgery. Do not try to get out of bed until your caregiver says it is okay.

  • Physical therapy: Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises help make your wrist and hand stronger. Do not use your wrist to pull until your caregiver says it is okay. Also, do not lift anything heavy.
  • Elevate: Your caregiver may tell you to raise your arm at different times during the day. Raising your arm may help decrease your pain.
  • Ice: Your caregiver may want you to put ice on your wrist and hand. This may help decrease your pain and swelling. Do not sleep with the ice pack on your wrist.
  • Medicines:
    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    • Pain medicine: You may need medicine to take away or decrease pain.
      • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
      • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

RISKS:

  • You may get an infection. Your skin may bruise. A thick, painful scar may form where you had surgery. You may get a trigger finger where your fingers are locked in a bent position. Surgery may cause long-term numbness or weakness in your fingers, hand, or wrist. Your symptoms may not go away, and you may need surgery again.
  • Without surgery, the symptoms of your CTS may get worse. You may not be able to work or do things you normally do. The muscles in your hand controlled by the compressed nerve may become smaller. You may not be able to feel or move your wrist.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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