Bupivacaine Hyalase Versus Dextrose 5% in Ultrasound Guided Hydrodissection of Median Nerve for Carpal Tunnel Syndrome: Comparative Randomized Study

Document Type : Original Article

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Department of Anesthesia, Surgical ICU and Pain Management Mansoura Faculty of Medicine ,Mansoura University, Egypt.

Abstract

Background: Carpal tunnel syndrome (CTS) is the most common focal entrapment neuropathy. The severity of the condition determines how CTS is managed. It is advised to try cautious treatment for mild to moderate instances.
Aim: In mild to moderate cases of carpal tunnel syndrome, this study compared the effectiveness of hyalase and dextrose 5% as adjuvants to the mixture of LAs in ultrasonography (US)-guided hydrodissection of the median nerve.
Methods: patients with mild-to-moderate CTS were divided into two groups; group-D (20 cases) with ultrasound guided dextrose 5% injection, and group-H (20 cases) with ultrasound guided hyalase injection .Electrophysiological nerve conduction velocity was assessed in millimeter/seconds at preinjection, postinjection 1 week, postinjection 1 month, postinjection 3 months and postinjection 6 months.
Results: baseline and one-week therapy scores on the Boston Carpal Tunnel Syndrome Questionnaire (BCTQs), showed no statistically significant change seen. Following treatment for one, three, and six months, group D's BCTQs score was statistically significantly lower. Sensory nerve conduction velocity (SNCV) of the two groups at baseline and one week after treatment, showed no statistically significant change. Following therapy for one, three, and six months, group D's SNCV was statistically significantly higher. Following three and six months of treatment, the CSA was statistically significantly lower in group D.
Conclusion : the Carpal tunnel HD approach, which uses 5% dextrose, is a viable treatment option for CTS sufferers, providing them with immediate and long-lasting pain relief.

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