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Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial
Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial
- Source :
- Scopus-Elsevier
- Publication Year :
- 2020
- Publisher :
- American Society of Interventional Pain Physicians, 2020.
-
Abstract
- Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. Objectives: To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. Study Design: A randomized, double-blinded trial. Setting: Anesthesia, pain, and rheumatology clinics in a university hospital. Methods: Patients: 60 patients with CTS (> 6 months’ duration). Intervention: patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). Measurements: assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. Results: Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. Limitation: We suggest a longer period could be reasonable. Conclusions: Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. Key words: Carpal tunnel syndrome, Hyalase, median nerve hydrodissection
- Subjects :
- Adult
Male
Visual analogue scale
medicine.medical_treatment
Neural Conduction
law.invention
03 medical and health sciences
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
030202 anesthesiology
law
Humans
Pain Management
Medicine
Carpal tunnel
Carpal tunnel syndrome
Saline
Ultrasonography, Interventional
medicine.diagnostic_test
business.industry
Dissection
Middle Aged
Wrist
medicine.disease
Carpal Tunnel Syndrome
Median nerve
Median Nerve
Treatment Outcome
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Anesthesia
Entrapment Neuropathy
Nerve conduction study
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 21501149 and 15333159
- Database :
- OpenAIRE
- Journal :
- Pain Physician
- Accession number :
- edsair.doi.dedup.....5dc190c3b5580ec3ecdfcda1c0f233a9
- Full Text :
- https://doi.org/10.36076/ppj.2020/23/e175