ObjectiveTo evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate.Material and methodsThis was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use of local anesthesia consisting of 20 mL of 1% lidocaine, adrenaline at 1:100,000 and 2 mL of sodium bicarbonate. The DASH scores before the operation and six months after the operation were evaluated. Comparisons were made regarding the intensity of pain at the time of applying the anesthetic and during the surgical procedure, and in relation to other types of procedure.ResultsThe DASH score improved from 65.17 to 16.53 six months after the operation (p < 0.01). In relation to the anesthesia, 75% of the patients reported that this technique was better than or the same as venous puncture and 81% reported that it was better than a dental procedure. Intraoperative pain occurred in two cases. There were no occurrences of ischemia.ConclusionUse of local anesthesia for surgically treating carpal tunnel syndrome is effective for performing the procedure and for the final result.

Como citar este artigo: Barros MFFH, et al. Avaliação do tratamento cirúrgico da síndrome do túnel do carpo com anestesia local. Rev Bras Ortop. 2015. http://dx.RBO-964; No. of Pages 4 r e v b r a s o r t o p . 2 0 1 5;x x x(x x):xxx-xxx w w w . r b o . o r g . b r Artigo original Avaliação do tratamento cirúrgico da síndrome do túnel do carpo com anestesia local ଝ On-line em xxx Palavras-chave: Síndrome do túnel do carpo Anestesia local Epinefrina r e s u m o Objetivo: Avaliar os resultados e as complicaç ões do tratamento cirúrgico da síndrome do túnel do carpo (STC) por via aberta, com o emprego da técnica anestésica local com uma solução composta por lidocaína, epinefrina e bicarbonato de sódio. Materiais e métodos: Estudo de coorte, por meio da avaliação dos prontuários de 16 pacientes submetidos a cirurgia aberta para STC com emprego de anestesia local com 20 mL de lidocaína 1%, adrenalina 1:100.000 e 2 mL de bicarbonato de sódio. Avaliação do escore DASH no pré e pós-operatório de seis meses e comparação da intensidade da dor durante o ato anestésico, durante a cirurgia e em relação a outros tipos de procedimentos. Resultados: O escore DASH melhorou de 65,17 para 16,53 no pós-operatório de seis meses (p < 0,01). Em relação à anestesia, 75% dos pacientes relataram que essa técnica é melhor ou igual a uma punção venosa e 81% relataram que é melhor do que um procedimento dentário. Em dois casos ocorreu dor no intraoperatório. Não ocorreram isquemias. Conclusão: O emprego de anestesia local para o tratamento cirúrgico da síndrome do túnel do carpo é eficaz para o procedimento e para o resultado final. © 2015 Sociedade Brasileira de Ortopedia e Traumatologia. Publicado por Elsevier Editora Ltda. Todos os direitos reservados. Evaluation of surgical treatment of carpal tunnel syndrome using local anesthesia Keywords: Carpal tunnel syndrome Local anesthesia Epinephrine a b s t r a c t Objective: To evaluate the results and complications from surgical treatment of carpal tunnel syndrome by means of an open route, using a local anesthesia technique comprising use of a solution of lidocaine, epinephrine and sodium bicarbonate. Material and methods: This was a cohort study conducted through evaluating the medical files of 16 patients who underwent open surgery to treat carpal tunnel syndrome, with use

Objective: To evaluate the complications inherent in the use or not of continuous suction drain in postoperative period of patients undergoing 1-level lumbar arthrodesis. Methods: An analytical, comparative, randomized study was performed with a sample of 60 patients submitted to 1-level 360 o lumbar arthrodesis with TLIF technique, 30 of whom used the suction drain for three days after surgery and another 30 did not use the suction drain in the postoperative period. The complications that occurred on the 3rd, 14th, and 28th postoperative days of patients of both groups and the Visual Analog Scale for pain were evaluated and compared. The complications assessed were seroma, superficial infection and suture dehiscence. Results: A total of 23.3% surgical wound complications were found, the most frequent being seroma (16%). In total, each group presented seven complications. There were no statistical differences observed in the evaluation of seroma, infection, wound dehiscence on the 3rd, 14th, and 28th postoperative days in both groups. Conclusion: The use or not of suction drain in 1-level lumbar surgeries does not interfere with complications such as seroma, infection, and suture dehiscence.Keywords: Arthrodesis; Spine; Spine fusion; Seroma; Surgical wound dehiscence; Infection. RESUMO

Introduction Research of degenerative diseases of the spine it is recommended performing radiographs and magnetic resonance imaging (MRI). Physiological curvature of the lumbar spine varies from 35 to 50. Changes sagittal alignment can lead to changes in the lumbar spine kinematics, having influence on the support and load distribution on the spine, causing low back pain. Methods 100 patients with chronic low back pain (51 men and 49 women), being evaluated degree of lumbar lordosis by three independent examiners by radiography in the standing position and MRI in supine position with flexed lower limbs. Measurement of lumbar lordosis by the Cobb method (L1 to L5 levels) in lumbar radiographs in profile and in the sagittal plane in lumbar MRI. Results Average of lumbar curvature on X-rays and the MRI cushion was 42,2° and 31,5°, respectively (p value < 0.001). Average angles of lumbar lordosis by MRI underestimates by 25% compared with lumbar radiographs. Conclusion MRI is insufficient for evaluation of lumbar lordosis, it underestimates the true lumbar lordosis. Thus, the lumbar radiological evaluation is essential in assessing the true lumbar lordosis.

Introduction antibiotic prophylaxis for patients undergoing lumbar spine arthrodesis is controversial in the literature. The objective of this article is comparing the results of post-operative patients undergoing lumbar spine arthrodesis using first generation cephalosporin antibioticoprofilaxiacom by one and five days. Methods we evaluated 43 patients aged between 16 and 76 years (mean 49.9 years), prospectively randomized, undergoing lumbar arthrodesis of 01 to 03 levels between November 2012 and April 2014, divided into two groups. At first it was used a period of antibiotic prophylaxis of a day and, in the second group, prevention was kept by 05 days. Following clinical and laboratory criteria were evaluated. Results the prevention of surgical infections requires far beyond the administration of antibiotics, according to the CDC's latest update, however, the dose, spectrum and time of use thereof remain controversial in the literature. The current recommendation for antibiotic prophylaxis in clean surgery of column is of single dose and, if a new dose is added, this should not exceed 24 hours the post-op. Conclusion A single dose of antibiotic prophylaxis with 1st generation cephalosporin is as effective as multiple doses scheme pre and post operative in lumbar arthrodesis surgery up to three levels, not justifying the costs and risks of submitting the patient hospitalization under medicated wide.