The Effect of Perineural Injection in the Treatment of Carpal Tunnel Syndrome

• Published in: QJM: An International Journal of Medicine
• Main Authors: Elsebaie, M A, Elarousi, N H, Elattar, E A, Mohamed, A A
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press (OUP) 2020
• Subjects: General Medicine; DML
• Online Access: http://dx.doi.org/10.1093/qjmed/hcaa064.009; http://academic.oup.com/qjmed/article-pdf/113/Supplement_1/hcaa064.009/33164082/hcaa064.009.pdf

Abstract Background This study was carried out to determine the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS. It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002). Objectives To study the effectiveness of perineural injection of dextrose 5 % buffered with sodium bicarbonate subcutaneously in treating patients with mild to moderate CTS. Patients and Methods It was a prospective randomized study that performed on twenty cases with idiopathic CTS; they were diagnosed clinically and electrophysiologically according to AANEM criteria (2002). All patients received PIT sessions. The injection done once weekly for 6 weeks. They were assessed before and after the treatment sessions by the following: provocative tests (Tinel, phalen and reverse phalen), clinical assessment scale (VAS and BCTQ"SSS, FSS") and nerve conduction study. Results By the end of the treatment, All provocative tests & All assessment scores showed a highly statistical significant difference (p > 0.01). Regarding sensory examination: night parethesia, hand pain and tingling &numbness showed a highly statistical significant difference (p > 0.01). Our results as regard nerve conduction studies of DML, sensory CV and DSL —difference between median and ulnar nerves showed that there was a statistical significant difference with improvement and there was a highly statistical significant difference with improvement as regard DSL and DML-difference between median and ulnar nerves. Before treatment VAS has a positive correlation with DML (r = 0.448, P < 0.05), another significant positive correlation was found between SSS and DSI (r = 0.45 , p < 0.05), but there was a negative correlation between VAS and the following MCV (r=-0.536, p < 0.05) and SCV (r= -0.462, p < 0.05). After treatment there was a negative correlation between VAS and the following SCV (r = -0.528, p < 0.05) and MCV (r= -0.618, p- 0,01 ). Conclusion Our study revealed that PIT Of D5W is an effective treatment for patients with mild to moderate CIS.