The Effect of Tourniquet Usage and Anesthesia Method on Prognosis in the Treatment of Dorsal Wrist Ganglion Cysts by Open Surgery

Abuzer Uludağ; Hacı Bayram Tosun; Mehmet Mete Yasar; Abdussamed Gunay; Bilge Aydin Turk; Öznur Uludağ

doi:10.7759/cureus.5981

The Effect of Tourniquet Usage and Anesthesia Method on Prognosis in the Treatment of Dorsal Wrist Ganglion Cysts by Open Surgery

Cureus. 2019 Oct 24;11(10):e5981. doi: 10.7759/cureus.5981.

Authors

Abuzer Uludağ¹, Hacı Bayram Tosun², Mehmet Mete Yasar¹, Abdussamed Gunay¹, Bilge Aydin Turk³, Öznur Uludağ⁴

Affiliations

¹ Orthopaedics, Adiyaman University Faculty of Medicine, Adiyaman, TUR.
² Orthopaedics, Istanbul Medipol University, Istanbul, TUR.
³ Pathology, Adiyaman University Faculty of Medicine, Adiyaman, TUR.
⁴ Anesthesiology and Reanimation, Adıyaman University Faculty of Medicine, Adıyaman, TUR.

Abstract

Introduction Ganglion cysts are the most common soft tissue masses seen on the wrist, which often cause pain or cosmetic complaints. The treatment of these masses includes intra-cystic injections or surgery. Recurrence rates are very high in surgical or non-surgical treatment. Inadequate excision for recurrence after surgery is blamed; however, the reasons for the recurrence still remain mysterious. Objectives In this study, the effect of anesthesia selection and tourniquet use on the dorsal wrist ganglion cysts in open surgery was investigated. Materials and methods Patients with dorsal wrist ganglion cysts, who were operated with open surgery between 2015 and 2018 and who had at least six months after the surgery, were examined. The patients were divided into two groups: patients who underwent surgery without tourniquet with local anesthesia and patients operated with tourniquet with general or regional anesthesia. Age, sex, cause of operation, visual analog scale (VAS) scores before and after surgery, limitation of movement, postoperative complications, and recurrence were compared. Results There was no significant difference between the groups in terms of causes of surgery, recurrence rates, preoperative and postoperative limitations of movement, and complications. In terms of age, the group operated with local anesthesia and without tourniquet was significantly larger. There was also no significant difference between the groups in terms of preoperative pain. Postoperative pain was significantly less in the group operated by tourniquet with general-regional anesthesia. Conclusion There is no significant difference in the recurrence and complications between patients operated under local anesthesia without tourniquets and patients operated with tourniquets under general or regional anesthesia during the open excision of the dorsal wrist ganglion cysts. However, it should be kept in mind that postoperative pain does not diminish in later ages, especially in cases of ganglion cysts, and other pathologies may also potentially cause pain in the wrist.

Keywords: anesthesia; ganglion; recurrence; tourniquet.