Variation in Surgeons' Requests for General Anesthesia When Scheduling Carpal Tunnel Release.

Hand : Official Journal of the American Association for Hand Surgery
Alex H S HarrisSeshadri C Mudumbai

Abstract

Background: Carpal tunnel release (CTR) can be performed with a variety of anesthesia techniques. General anesthesia is associated with higher risk profile and increased resource utilization, suggesting it should not be routinely used for CTR. The purpose of this study was to examine the patient factors associated with surgeons' requests for general anesthesia for CTR and the frequency of routine use of general anesthesia by Veterans Health Administration (VHA) surgeons and facilities. Methods: National VHA data for fiscal years 2015 and 2017 were used to identify patients receiving CTR. Mixed-effects logistic regression was used to evaluate patient, procedure, and surgeon factors associated with requests by the surgeon for general anesthesia versus other anesthesia techniques. Results: In all, 18 145 patients underwent CTR performed by 780 surgeons in 113 VHA facilities. Overall, there were 2218 (12.2%) requests for general anesthesia. Although some patient (eg, older age, obesity), procedure (eg, open vs endoscopic), and surgeon (eg, higher volume) factors were associated with lower odds of requests for general anesthesia, there was substantial facility- and surgeon-level variability. The percentage of patients with general a...Continue Reading

References

Jan 31, 2002·Anesthesiology·UNKNOWN American Society of Anesthesiologists Task Force on Preanesthesia Evaluation
Jun 14, 2006·ANZ Journal of Surgery·Murray J Stapleton
Sep 10, 2008·Hand : Official Journal of the American Association for Hand Surgery·Martin R LeblancDonald H Lalonde
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Feb 21, 2013·Scandinavian Journal of Work, Environment & Health·Ann Marie DaleBradley Evanoff
Jan 9, 2014·BMC Musculoskeletal Disorders·Nitin B JainJeffrey N Katz
Jan 16, 2014·Hand : Official Journal of the American Association for Hand Surgery·Peter G DavisonDonald H Lalonde
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Nov 20, 2016·The Journal of Hand Surgery·Joshua W HustedtScott G Edwards
Mar 28, 2017·Hand : Official Journal of the American Association for Hand Surgery·Brock D FosterAlidad Ghiassi

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