Open Carpal Tunnel Decompression by Specialist versus Nurse Practitioner. (December 2015)

• Record Type: Journal Article
• Authors: Patel, Nimesh; Roberton, Andy; Batten, Timothy; Millyard, Cathy; Birdsall, Paul
• Is Part Of: Journal of orthopaedic surgery. Volume 23:Number 3(2015)
• Page Start: 349
• Page End: 351
• Publication Date: 2015-12
• Subjects: carpal tunnel syndrome -- decompression, surgical -- nurses; Orthopedic surgery -- Periodicals; Orthopedics; Orthopedic surgery; Periodicals; 617.3
• DOI: 10.1177/230949901502300319
• Languages: English
• ISSNs: 1022-5536

Abstract

Purpose: To compare the outcome after open carpal tunnel decompression by specialists versus a nurse practitioner. Methods: Of 1361 cases of open carpel tunnel decompression under local anaesthesia from 1996 to 2008, 807 were performed by specialists (consultant, specialist registrar, or specialty and associate specialist) and 554 by a nurse practitioner (since May 2006). The 2 groups were compared in terms of surgical time, total theatre time, postoperative pain, and patient satisfaction with the service. Results: The mean surgical time was shorter in cases performed by specialists (13 vs. 18 minutes, p<0.0001), as was the mean total theatre time (26 vs. 29 minutes, p=0.0154). The rate of postoperative pain was higher in cases performed by specialists (31.5% vs. 24.5%, p=0.0125), as was the rate of patient dissatisfaction (1.6% vs. 0.18%, 0.0113). Nonetheless, since May 2006, outcome was comparable for specialists and the nurse practitioner. This could be due to the change from short-acting to long-acting/mixed local anaesthetic, and the technique for infiltration. The waiting time for surgery reduced from a mean of 16 to 3 weeks. Conclusion: Specialists and the nurse practitioner achieved comparable outcome after open carpal tunnel decompression.