CONSENSUS RECOMMENDATION There are no studies evaluating the utilization of pre-operative testing (e.g., labs, CXR, EKG) for carpal tunnel patients only. One study evaluated the use of pre-operative testing for patients with common hand conditions (including carpal tunnel) and demonstrated increased generation of downstream tests, procedures, and costs. Studies outside of hand surgery consistently demonstrate that pre-operative testing for healthy patients undergoing minor procedures leads to delays in care, unnecessary downstream testing and care, and added costs.
Benefits/Harms of Implementation
The potential benefits of this recommendation include decreasing the utilization of unnecessary testing that has the potential to lead to increased costs, delays in care, and downstream care cascades. The potential harm is missing a critical test result that may impact care or the patient’s health. In healthy patients, this risk and thus potential harm is low. As such, the working group recommends that peri-operative testing not be performed routinely on healthy patients before carpal tunnel release and may be utilized on a case-by-case basis for non-healthy patients when it may impact their anesthetic type or peri-operative care.