Different Sessions of Perineural Injection With Dextrose for Carpal Tunnel Syndrome

  • STATUS
    Recruiting
  • End date
    Jul 31, 2022
  • participants needed
    75
  • sponsor
    Tri-Service General Hospital
Updated on 17 February 2021
corticosteroids
5% dextrose
neuropathy
injection therapy
entrapment neuropathies
electrophysiological studies

Summary

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with involving compression of the median nerve in the carpal tunnel. The technique of perineural injection therapy (PIT) by using 5% dextrose (D5W) is now commonly used for peeling the nerve from surrounding soft tissue (called nerve hydrodissection), which may help antineurogenic inflammation, allow the impulse to pass, and rescue the nerve with ischemic damage. However, the evidence and reference of PIT and nerve hydrodissection are very seldom until our series researches since 2017. Moreover, our research revealed PIT with D5W is more beneficial than that of corticosteroid in patients with mild-to-moderate CTS at 4 to 6 months postinjection. However, the accumulative effect and long-term effect (more than 6 months) of PIT is still unknown. Hence, we design a randomized, double- blind, controlled trail to assess the long-term effect of ultrasound-guided PIT in patients with CTS. The aim one is to survey the possible accumulative effect of different sessions of PIT (6 months follow-up) and aim two is to evaluate the long-term effect and safety of PIT (one year follow-up).

Description

After obtaining written informed consent, patients clinically diagnosed with mild-to-moderate CTS were includes and randomized into three groups. Group A, patients received two-sessions of ultrasound-guided PIT with 10cc D5W (3 months interval); Group B, patients received one-session of ultrasound-guided PIT with 10cc D5W and 5cc normal saline separately (3 months interval); Group C (control group), patients received two-sessions of ultrasound-guided PIT with nerve hydrodissection with 10cc normal saline. The primary outcome is Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and secondary outcomes include visual analog scale (VAS), cross-sectional area (CSA) of the median nerve, nerve conduction velocity of the median nerve, and Global assessment of treatment. The evaluations were performed pretreatment as well as on the 1st, 3rd, 6th, 9th month and one year after first injection.

Details
Condition Carpal Tunnel Syndrome
Treatment two-sessions of ultrasound-guided PIT, One-sessions of ultrasound-guided PIT, Placebo ultrasound-guided injection with nerve hydrodissection
Clinical Study IdentifierNCT03802435
SponsorTri-Service General Hospital
Last Modified on17 February 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Age between 20-80 year-old
Diagnosis was confirmed using an electrophysiological study

Exclusion Criteria

Cancer
Coagulopathy
Pregnancy
Inflammation status
Cervical radiculopathy
Polyneuropathy, brachial plexopathy
Thoracic outlet syndrome
Previously undergone wrist surgery or steroid injection for CTS
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