Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients: Carpal Tunnel Syndrome

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Abstract

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.

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Most cited references 34

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A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome.

L Daltroy, A Fossel, J N Katz … (1993)

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A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire

José Leite, Christina Jerosch-Herold, Fujian Song (2006)

Background The Boston Carpal Tunnel Questionnaire (BCTQ) is a disease-specific measure of self-reported symptom severity and functional status. It is frequently used in the reporting of outcomes from trials into interventions for carpal tunnel syndrome. We conducted a systematic review of published studies on the psychometric properties of the BCTQ to determine the level of evidence on the instrument's validity, reliability and responsiveness to date. Methods A search of the databases Medline, CINAHL, AMED and PsychInfo was conducted to retrieve studies which investigated one or more of the psychometric properties of the BCTQ. Data abstraction was undertaken by the first two authors. Results Ten studies were retrieved which met the inclusion criteria. One study evaluated face and content validity (43 patients) eight studies assessed construct validity (932 patients), four studies tested reliability (126 patients) and nine studies assessed responsiveness (986 patients). Interpretability was evaluated in one study and acceptability in eight studies (978 patients). Conclusion The BCTQ is a standardised, patient-based outcome measure of symptom severity and functional status in patients with carpal tunnel syndrome. The evidence base of the psychometric properties indicates that the BCTQ is a valid, reliable, responsive and acceptable instrument and should be included as a primary outcome measures in future CTS trials.

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Literature review of the usefulness of nerve conduction studies and electromyography for the evaluation of patients with carpal tunnel syndrome. AAEM Quality Assurance Committee.

C Jablecki, M T Andary, Y So … (1993)

The sensitivity and specificity of nerve conduction studies (NCS's) and electromyography (EMG) for the diagnosis of carpal tunnel syndrome (CTS) were evaluated by a critical review of the literature. With a search of the medical literature in English through May 1991, 165 articles were identified and reviewed on the basis of six criteria of scientific methodology. The findings of 11 articles that met all six criteria and the results of 48 additional studies that met four or five criteria are presented. We concluded that median sensory and motor NCS's are valid and reproducible clinical laboratory studies that confirm a clinical diagnosis of CTS with a high degree of sensitivity and specificity. Clinical practice recommendations are made based on a comparison of the sensitivities of the several different median nerve conduction study (NCS) techniques.

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Author and article information

Journal

Title: Annals of Neurology

Abbreviated Title: Ann Neurol.

Publisher: Wiley

ISSN: 03645134

Publication date Created: October 2018

Publication date (Print): October 2018

Publication date (Electronic): October 04 2018

Volume: 84

Issue: 4

Pages: 601-610

Affiliations

[1 ]Department of Physical Medicine and Rehabilitation

[2 ]Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center; Taipei Taiwan Republic of China