Randomized double‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients
Objective Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating...
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Veröffentlicht in: | Annals of neurology 2018-10, Vol.84 (4), p.601-610 |
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creator | Wu, Yung‐Tsan Ke, Ming‐Jen Ho, Tsung‐Yen Li, Tsung‐Ying Shen, Yu‐Ping Chen, Liang‐Cheng |
description | Objective
Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double‐blinded, head‐to‐head comparative trial to compare these two approaches for patients having mild‐to‐moderate CTS.
Methods
Fifty‐four participants with mild‐to‐moderate CTS were randomly divided into dextrose and steroid groups. The patients were administered 1 session of perineural injection with 5ml D5W (dextrose group) or 3ml triamcinolone acetonide mixed with 2ml normal saline (steroid group), under ultrasound guidance. A visual analog scale was assigned to assess the primary outcome. The secondary outcomes were assessed using the Boston Carpal Tunnel Syndrome Questionnaire, cross‐sectional area of the median nerve, and electrophysiological studies. The assessment was performed prior to injection and 1, 3, 4, and 6 months postinjection.
Results
All patients (27 wrists per group) completed the study. Compared with the steroid group, the dextrose group exhibited a significant reduction in pain and disability through the 4th to the 6th month (p |
doi_str_mv | 10.1002/ana.25332 |
format | Article |
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Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double‐blinded, head‐to‐head comparative trial to compare these two approaches for patients having mild‐to‐moderate CTS.
Methods
Fifty‐four participants with mild‐to‐moderate CTS were randomly divided into dextrose and steroid groups. The patients were administered 1 session of perineural injection with 5ml D5W (dextrose group) or 3ml triamcinolone acetonide mixed with 2ml normal saline (steroid group), under ultrasound guidance. A visual analog scale was assigned to assess the primary outcome. The secondary outcomes were assessed using the Boston Carpal Tunnel Syndrome Questionnaire, cross‐sectional area of the median nerve, and electrophysiological studies. The assessment was performed prior to injection and 1, 3, 4, and 6 months postinjection.
Results
All patients (27 wrists per group) completed the study. Compared with the steroid group, the dextrose group exhibited a significant reduction in pain and disability through the 4th to the 6th month (p < 0.01).
Interpretation
Our study demonstrates that perineural injection of D5W is more beneficial than that of corticosteroid in patients with mild‐to‐moderate CTS at 4 to 6 months postinjection. Ann Neurol 2018;84:601–610</description><identifier>ISSN: 0364-5134</identifier><identifier>EISSN: 1531-8249</identifier><identifier>DOI: 10.1002/ana.25332</identifier><identifier>PMID: 30187524</identifier><language>eng</language><publisher>United States</publisher><ispartof>Annals of neurology, 2018-10, Vol.84 (4), p.601-610</ispartof><rights>2018 American Neurological Association</rights><rights>2018 American Neurological Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3252-1365b787df007f6c8a656896d67ce5026c150304220f0e8b6f4ee11ca3c6b45f3</citedby><cites>FETCH-LOGICAL-c3252-1365b787df007f6c8a656896d67ce5026c150304220f0e8b6f4ee11ca3c6b45f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fana.25332$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fana.25332$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30187524$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Yung‐Tsan</creatorcontrib><creatorcontrib>Ke, Ming‐Jen</creatorcontrib><creatorcontrib>Ho, Tsung‐Yen</creatorcontrib><creatorcontrib>Li, Tsung‐Ying</creatorcontrib><creatorcontrib>Shen, Yu‐Ping</creatorcontrib><creatorcontrib>Chen, Liang‐Cheng</creatorcontrib><title>Randomized double‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients</title><title>Annals of neurology</title><addtitle>Ann Neurol</addtitle><description>Objective
Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double‐blinded, head‐to‐head comparative trial to compare these two approaches for patients having mild‐to‐moderate CTS.
Methods
Fifty‐four participants with mild‐to‐moderate CTS were randomly divided into dextrose and steroid groups. The patients were administered 1 session of perineural injection with 5ml D5W (dextrose group) or 3ml triamcinolone acetonide mixed with 2ml normal saline (steroid group), under ultrasound guidance. A visual analog scale was assigned to assess the primary outcome. The secondary outcomes were assessed using the Boston Carpal Tunnel Syndrome Questionnaire, cross‐sectional area of the median nerve, and electrophysiological studies. The assessment was performed prior to injection and 1, 3, 4, and 6 months postinjection.
Results
All patients (27 wrists per group) completed the study. Compared with the steroid group, the dextrose group exhibited a significant reduction in pain and disability through the 4th to the 6th month (p < 0.01).
Interpretation
Our study demonstrates that perineural injection of D5W is more beneficial than that of corticosteroid in patients with mild‐to‐moderate CTS at 4 to 6 months postinjection. Ann Neurol 2018;84:601–610</description><issn>0364-5134</issn><issn>1531-8249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kMFqFTEUQINU7LO68Ackm0JdTHuTTDLzlo-iVigKoushk9xASiZ5JjOtT7roJ_iNfolpX3XXTS4kJwfuIeQNg1MGwM901KdcCsGfkRWTgjU9b9cHZAVCtY1koj0kL0u5AoC1YvCCHApgfSd5uyK3X3W0afK_0FKbljHgn7vfY_DR1gtTpzc60Dn7eiZH5TG1-HPOqSC9xlyW8vA2GR9TSBGpj1doZp8idSlTo_P2_vsSIwZadtHmNCHd6tljnMsr8tzpUPD14zwi3z-8_3Z-0Vx--fjpfHPZGMElb5hQcuz6zjqAzinTayVVv1ZWdQYlcGWYBAEt5-AA-1G5FpExo4VRYyudOCIne-82px8LlnmYfDEYgo6YljLwWlFUgZIVfbdHTd2xZHTDNvtJ593AYLiPPdTYw0Psyr591C7jhPY_-a9uBc72wI0PuHvaNGw-b_bKv1tYixc</recordid><startdate>201810</startdate><enddate>201810</enddate><creator>Wu, Yung‐Tsan</creator><creator>Ke, Ming‐Jen</creator><creator>Ho, Tsung‐Yen</creator><creator>Li, Tsung‐Ying</creator><creator>Shen, Yu‐Ping</creator><creator>Chen, Liang‐Cheng</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201810</creationdate><title>Randomized double‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients</title><author>Wu, Yung‐Tsan ; Ke, Ming‐Jen ; Ho, Tsung‐Yen ; Li, Tsung‐Ying ; Shen, Yu‐Ping ; Chen, Liang‐Cheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3252-1365b787df007f6c8a656896d67ce5026c150304220f0e8b6f4ee11ca3c6b45f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Yung‐Tsan</creatorcontrib><creatorcontrib>Ke, Ming‐Jen</creatorcontrib><creatorcontrib>Ho, Tsung‐Yen</creatorcontrib><creatorcontrib>Li, Tsung‐Ying</creatorcontrib><creatorcontrib>Shen, Yu‐Ping</creatorcontrib><creatorcontrib>Chen, Liang‐Cheng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Yung‐Tsan</au><au>Ke, Ming‐Jen</au><au>Ho, Tsung‐Yen</au><au>Li, Tsung‐Ying</au><au>Shen, Yu‐Ping</au><au>Chen, Liang‐Cheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized double‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients</atitle><jtitle>Annals of neurology</jtitle><addtitle>Ann Neurol</addtitle><date>2018-10</date><risdate>2018</risdate><volume>84</volume><issue>4</issue><spage>601</spage><epage>610</epage><pages>601-610</pages><issn>0364-5134</issn><eissn>1531-8249</eissn><abstract>Objective
Perineural injection with 5% dextrose (D5W) is a novel strategy in the treatment of carpal tunnel syndrome (CTS). In contrast, perineural injection with corticosteroid has been used for decades for treating CTS, but possible neurotoxicity has been a major concern. No studies investigating the comparative effects have been published so far. The authors performed a prospective, randomized, double‐blinded, head‐to‐head comparative trial to compare these two approaches for patients having mild‐to‐moderate CTS.
Methods
Fifty‐four participants with mild‐to‐moderate CTS were randomly divided into dextrose and steroid groups. The patients were administered 1 session of perineural injection with 5ml D5W (dextrose group) or 3ml triamcinolone acetonide mixed with 2ml normal saline (steroid group), under ultrasound guidance. A visual analog scale was assigned to assess the primary outcome. The secondary outcomes were assessed using the Boston Carpal Tunnel Syndrome Questionnaire, cross‐sectional area of the median nerve, and electrophysiological studies. The assessment was performed prior to injection and 1, 3, 4, and 6 months postinjection.
Results
All patients (27 wrists per group) completed the study. Compared with the steroid group, the dextrose group exhibited a significant reduction in pain and disability through the 4th to the 6th month (p < 0.01).
Interpretation
Our study demonstrates that perineural injection of D5W is more beneficial than that of corticosteroid in patients with mild‐to‐moderate CTS at 4 to 6 months postinjection. Ann Neurol 2018;84:601–610</abstract><cop>United States</cop><pmid>30187524</pmid><doi>10.1002/ana.25332</doi><tpages>28</tpages></addata></record> |
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title | Randomized double‐blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients |
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