Hand · IF 1.6 · October 1, 2026 · LoE III
Non-tobacco Nicotine Dependence Is Associated With Increased Perioperative Complications After Carpal Tunnel Release
William H. Rankin, Alejandro M. Holle, Michael Lane Moore, Kevin J. Renfree — Mayo Clinic
This retrospective study used a large US insurance claims database to compare carpal tunnel release patients coded with non-tobacco nicotine dependence (such as vaping, gum, or patches) against propensity-matched non-users and against tobacco smokers. Compared with non-users, the non-tobacco nicotine group had more 90-day medical complications (2.4% vs 1.7%; odds ratio 1.35, 95% CI 1.04 to 1.77) and more emergency visits (10.3% vs 8.1%). Compared with smokers, they had fewer emergency visits (10.4% vs 14.2%) and slightly fewer 2-year revisions (1.9% vs 2.5%).
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersE-cigarette use is rising fast, and this suggests nicotine itself, not just smoke, may be linked to more complications after one of the most common hand operations.
Conclusion strengthConfirms prior evidence
This identifies a risk factor rather than testing a treatment, so it cannot support a change in what we do.
Presenting this at rounds? Start here
- ?Should surgeons ask specifically about vaping, pouches, and nicotine replacement products during preoperative counseling for carpal tunnel release, and how should a positive answer change the consent discussion?
- ?Given that nicotine replacement therapy is often used to help smokers quit before surgery, how would you counsel a smoker scheduled for carpal tunnel release about switching to non-tobacco nicotine versus stopping nicotine entirely?