A new retrospective study comparing carpal tunnel release performed at an ASC against a clinic-based procedure suite found no meaningful difference in patient outcomes, but a stark gap in efficiency that could push more of these cases out of the ASC altogether.
The study, published in The Iowa Orthopaedic Journal, followed 165 adult patients treated by a single surgeon between January 2022 and December 2023. Of those, 136 underwent carpal tunnel release in an ASC operating room, either under wide-awake local anesthesia no tourniquet or monitored anesthesia care; the other 29 were treated in a clinic procedure suite using WALANT, which does not require presurgical fasting.
Patients treated at the ASC spent an average of 178.36 minutes in the facility on the day of surgery, compared with 86.93 minutes for procedure-suite patients, a difference of 91.42 minutes. Validated patient-reported outcome scores, including PROMIS and QuickDASH measures, showed no statistically significant differences between the two settings, nor did patient demographics.
The study’s authors did not perform their own cost analysis but cited prior research finding operating-room-based carpal tunnel release can cost six to 29 times more than the same case performed in a procedure suite.
The authors recommend carpal tunnel release be performed in a procedure suite “when possible,” while noting some patients will still require an OR setting, leaving ASCs a role, but a narrower one, in this case type.
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