Abstract
Background Open carpal tunnel release (CTR) is one of the most commonly performed operative
procedures with operative duration being a primary metric of operating room efficiency.
The purpose of this study was to identify factors associated with prolonged operative
duration, in performing CTR.
Materials and Methods CTR cases performed by a single surgeon from September 2013 to October 2015 were
reviewed. Patient age at the time of surgery, sex, location of surgery (specialty
orthopaedic hospital versus ambulatory surgery center), body mass index (BMI), American
Society of Anesthesiologists classification, total operative duration (TOD), and procedure
time (PT) were recorded. Obesity was defined as BMI > 30 and morbid obesity was defined
as BMI > 35. Data were analyzed to identify factors associated with prolonged TOD
or PT.
Results One hundred and nine consecutive patients underwent isolated CTR. Mean age at time
of surgery was 62 years (range: 24–92 years). Nonobese patients were found to have
significantly shorter TOD than obese patients (22.3 vs. 24.4 minutes). Similarly,
patients who were not morbidly obese had significantly shorter TOD than morbidly obese
patients (22.6 vs. 26 minutes). No other factors were associated with prolonged TOD.
No difference in PT was found between normal weight, obese, and morbidly obese groups.
Conclusions TOD, but not procedure time, is significantly affected by obesity. Our findings are
relevant when scheduling and preparing obese patients for surgery, which may have
a significant impact on health resource utilization.
Level of Evidence This is a Level III, economic/decision analysis study.
Keywords
carpal tunnel release - efficiency - obesity - operating duration - risk factors
