Residual Symptoms After Carpal Tunnel Decompression and Treatment With Gabapentin: A Multicenter Study

Abstract

Objectives To identify postoperative residual symptoms of carpal tunnel syndrome (CTS) and to investigate the effectiveness of gabapentin in the treatment of residual symptoms. Materials and methods Of a total of 412 patients who underwent surgery for CTS in four centers over a four-year period, 14 who had residual symptoms after CTS release and did not receive gabapentin (Group A) and 14 patients with postoperative residual symptoms and received gabapentin were included in this retrospective study. Postoperative residual symptoms were defined as persistent nocturnal numbness and tingling with or without occasional daytime pain. Tinel’s and Phalen’s tests were performed for the diagnosis of residual symptoms. Functional Severity Score (FSS), Symptom Severity Score (SSS), and Visual Analog Scale (VAS) were used to evaluate functional outcomes, severity of symptoms, and numbness and sleep quality, respectively at six and 12 weeks postoperatively. Level of Evidence: III, therapeutic study Results There was no statistically significant difference in the mean postoperative FSS (p=0.845) and VAS-numbness scores (p=0.367) between the groups. However, there was a statistically significant difference in the mean postoperative SSS (p=0.025) and VAS-sleep quality scores (p<0.001) between the groups. Conclusion Gabapentin treatment can be a treatment of choice for residual symptoms after CTS surgery and clinical improvement can be achieved owing to its relieving effect, particularly in nocturnal symptoms of patients having neuropathic pain.

The Influence of Wound Closure Techniques after Surgical Decompression in Patients with Carpal Tunnel Syndrome on Sleep Disturbance and Life Quality: A Prospective Comparison of Surgical Techniques

“…It has been proven that surgical decompression of the carpal tunnel is successful in improving the sleep and quality of life of patients with CTS [3]. Even non-surgical methods such as steroid injection treatment or medicaments have a significant effect on sleep improvement in patients with CTS [4,5]. It is of the utmost importance for the patient to achieve relief of night paresthesia and improved quality of sleep by treating CTS, which then has an impact on their quality of life and ability to work [6].…”

Efficiency of Direct Transcutaneous Electroneurostimulation of the Median Nerve in the Regression of Residual Neurological Symptoms after Carpal Tunnel Decompression Surgery

“…The greatest effect of CTDS develops 6–12 months after the surgery [ 4 , 5 ]. Nocturnal numbness and tingling, with occasional daytime pain, persist after CTDS in 8.56% of patients [ 6 , 7 ]. The cause of residual neurological disorders after CTDS is incomplete surgical relaxation, due to the complexity of the surgical exploration of the distal transverse carpal ligament and the proximal antebrachial fascia [ 8 ].…”

“…Conservative treatment of residual symptoms after CTDS begins with the use of central analgesics to relieve neuropathic pain syndrome [ 6 ]. The effectiveness of physiotherapy methods for the treatment of residual neurological symptoms after CTDS, using manual therapy [ 17 , 18 ], low-intensity laser therapy [ 19 , 20 , 21 ], acupuncture [ 22 , 23 , 24 ], and electroacupuncture [ 25 ], as well as extracorporeal shock wave therapy [ 26 ], has been proven in many studies.…”