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A Comparative Study between Five Percent Dextrose-water
Solution and Triamcinolone in Intracarpal Injection for Treat-
ment of Carpal Tunnel Syndrome: Randomized Double-blinded
Controlled Trial
Kittipot Surasit1, Chuenchom Chueluecha2, Chinnakart Boonyasirikool1*
1 Department of Orthopedics, Faculty of Medicine, Thammasat University
2 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Thammasat University
*Corresponding Author E-mail: chinnakartb@gmail.com
Background: Abstract
Perineural injection of 5% dextrose is a new treatment for carpal tunnel syndrome (CTS).
A comparative study found that 5% dextrose was more effective than steroids. However,
research on its efficacy via conventional intracarpal injection is limited. This study aims to
compare the effectiveness of a 5% dextrose-water solution with triamcinolone acetonide,
without using nerve hydro-dissection.
Methods: This study was a randomized, controlled, double-blind trial involving participants with mild
to moderate CTS. They were divided into two groups: one received a 5 ml injection of 5%
dextrose-water, while the other received 40 mg of triamcinolone with normal saline to a
total volume of 5 ml. The primary outcome was assessed using the Boston Carpal Tunnel
Syndrome Questionnaire (BCTQ), and secondary outcomes included Semmes-Weinstein
monofilament sensitivity, two-point discrimination, grip strength, and nerve conduction
studies. Assessments were conducted prior to the injection and again at 1, 3, and 6 months,
although nerve conduction studies were performed only at baseline, 3 months, and 6
months.
Results: Conclusion: The study involved 66 participants (33 wrists per group).8 participants (4 from each group)
required surgery due to clinical deterioration, leaving 58 participants (29 wrists per group)
for analysis. Both groups demonstrated significant improvement in BCTQ scores (p<0.01)
over the 6 months. However, the dextrose group did not show significant improvements
compared to the steroid group. Notably, there were no complications associated with the
injections in either group.
A 5% dextrose water solution can effectively treat mild to moderate carpal tunnel syndrome
without the need for ultrasound-guided perineural injection. Additionally, dextrose may be
used as an alternative to steroids if there are concerns about neurotoxicity.
Harmony in health: Innovation for Sustainable Medicine
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