Ignacio Rellan, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pablo De Carli, Pedro Bronenberg Victorica, Rocio Avanzi, Ivan Alfredo Huespe, Jorge Guillermo Boretto
{"title":"Pillar pain incidence, duration, and psychological correlations in WALANT. A prospective study of 170 patients.","authors":"Ignacio Rellan, Agustín Guillermo Donndorff, Gerardo Luis Gallucci, Pablo De Carli, Pedro Bronenberg Victorica, Rocio Avanzi, Ivan Alfredo Huespe, Jorge Guillermo Boretto","doi":"10.1016/j.jham.2024.100165","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To prospectively address our patients seeking carpal tunnel release (CTR) to evaluate the incidence, intensity, and duration of pillar pain (PP) and its correlation with catastrophic thinking, depression, and health anxiety.Methods: this is a prospective cohort study consisting of patients who underwent mini-open CTR under WALANT. Pillar pain was evaluated using the table test and was recorded as dichotomous variable and rated with a visual analogue scale (VAS). Patients with a positive result were evaluated on a monthly basis until the test yielded a negative result.To assess catastrophic thinking, health anxiety and depression levels, we employed the Pain Catastrophizing Scale (PCS) the Short Health Anxiety Inventory (SHAI), and the Beck scale respectively.</p><p><strong>Results: </strong>The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).</p><p><strong>Conclusion: </strong>Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.</p><p><strong>Type of study/level of evidence: </strong>Prognostic II.</p>","PeriodicalId":45368,"journal":{"name":"Journal of Hand and Microsurgery","volume":"17 2","pages":"100165"},"PeriodicalIF":0.3000,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173819/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand and Microsurgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.jham.2024.100165","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To prospectively address our patients seeking carpal tunnel release (CTR) to evaluate the incidence, intensity, and duration of pillar pain (PP) and its correlation with catastrophic thinking, depression, and health anxiety.Methods: this is a prospective cohort study consisting of patients who underwent mini-open CTR under WALANT. Pillar pain was evaluated using the table test and was recorded as dichotomous variable and rated with a visual analogue scale (VAS). Patients with a positive result were evaluated on a monthly basis until the test yielded a negative result.To assess catastrophic thinking, health anxiety and depression levels, we employed the Pain Catastrophizing Scale (PCS) the Short Health Anxiety Inventory (SHAI), and the Beck scale respectively.
Results: The study enrolled 170 patients who underwent CTR using WALANT technique. Among them, 84 patients (49 %) exhibited a positive table test. With exception of age and diabetes, both groups showed comparable demographic characteristics.The mean pain score for patients with a positive test was 3.5 ± 1.5, and the median duration of it was 3 months (interquartile range [IQR] 2-4). The median PCS score was 8 (IQR 2-14) in patients without PP, compared to 8 (IQR 4-11) in patients with PP. In the logistic regression model, the PCS variable had a crude odds ratio (OR) of 1 (95 % CI: 0.96-1.03) and an adjusted OR of 1 (95 % CI: 0.97-1.04). The SHAI score showed a crude OR of 0.97 (95 % CI: 0.93-1.01) and an adjusted OR of 0.97 (95 % CI: 0.92-1.01). The BECK score had a crude OR of 0.99 (95 % CI: 0.96-1.03) and an adjusted OR of 1.02 (95 % CI: 0.98-1.06).
Conclusion: Patients undergoing mini-open CTR have a risk of 49 % of experiencing PP, which typically registers a pain intensity of approximately 3 points and will last for a median of 3 months. The likelihood of experience it does not depend on catastrophic thinking, depression, and health anxiety.
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