RCT#1 Cubital tunnel treatment with D5W versus a steroid, triamcinolone acetonide. (Ulnar nerve treatment at the elbow)
This randomized, blinded, and controlled trial on hydrodissection using 5% dextrose in water (D5W) versus steroid was published in the Archives of Physical Medicine and Rehabilitation by Dr. Chen et al. in 2020.
Chen L, Ho, TY, Shen YP, Su UC. :o TU. Tsao CL. Wu YT. Perineural dextrose and corticosteroid injections for ulnar neuropathy at the elbow: A randomized double-blind trial. Arch Phys Med Rehabil 2020;101:1296-303.
This was a single injection study of participants with cubital tunnel syndrome (compression of the "funny bone nerve, also known as the ulnar nerves" as it travels across the elbow. Ultrasound guidance was used to hydrodissect about the ulnar nerve with either D5W or a steroid (triamcinolone acetonide), a total of 30 mg, mixed with normal saline. Pain improvements were similar and substantial in both groups. The ulnar nerve size (swelling) decreased more in the dextrose group. Here is that abstract.
ABSTRACT
Objective: To assess the effects of perineural corticosteroid and 5% dextrose water (D5W) injections in patients with mild to moderate ulnar neuropathy at the elbow (UNE).
Design: Prospective, randomized, double-blind, controlled trial (6-month follow-up).
Setting: Outpatients of local medical center settings.
Participants: Patients (N=36) with mild to moderate UNE were randomized, and 33 participants were included in the final data analysis.
Interventions: Patients were administered a single perineural injection with 5 mL D5W and 3 mL corticosteroid (triamcinolone acetonide, 10mg/mL) mixed with 2 mL normal saline under ultrasound guidance in the dextrose and steroid groups, respectively.
Main outcome measures: The visual analog scale digital pain or paresthesia/dysesthesia score was the primary outcome. The secondary outcomes were the Disabilities of the Arm, Shoulder, and Hand questionnaire, motor nerve conduction velocity, and cross-sectional area (CSA) of the ulnar nerve. The measurement assessment was conducted before and 1, 3, 4, and 6 months after injection.
Results: Thirty-three patients completed the study. Both injections were found to be equally effective at most measurement points, although the dextrose group experienced larger reductions in symptom severity and CSA of the ulnar nerve from the third month onward.
Conclusions: We suggest D5W as a more suitable injectate for perineural injection in patients with UNE.
This randomized, blinded, and controlled trial on hydrodissection using 5% dextrose in water (D5W) versus steroid was published in the Archived of Physical Medicine and Rehabilitation by Dr. Chen et al. in 2020.
Chen L, Ho, TY, Shen YP, Su UC. :o TU. Tsao CL. Wu YT. Perineural dextrose and corticosteroid injections for ulnar neuropathy at the elbow: A randomized double-blind trial. Arch Phys Med Rehabil 2020;101:1296-303.
This was a single injection study of participants with cubital tunnel syndrome (compression of the "funny bone nerve, also known as the ulnar nerves" as it travels across the elbow. Ultrasound guidance was used to hydrodissect about the ulnar nerve with either D5W or a steroid (triamcinolone acetonide), a total of 30 mg, mixed with normal saline. Pain improvements were similar and substantial in both groups. The ulnar nerve size (swelling) decreased more in the dextrose group. Here is that abstract.
ABSTRACT
Objective: To assess the effects of perineural corticosteroid and 5% dextrose water (D5W) injections in patients with mild to moderate ulnar neuropathy at the elbow (UNE).
Design: Prospective, randomized, double-blind, controlled trial (6-month follow-up).
Setting: Outpatients of local medical center settings.
Participants: Patients (N=36) with mild to moderate UNE were randomized, and 33 participants were included in the final data analysis.
Interventions: Patients were administered a single perineural injection with 5 mL D5W and 3 mL corticosteroid (triamcinolone acetonide, 10mg/mL) mixed with 2 mL normal saline under ultrasound guidance in the dextrose and steroid groups, respectively.
Main outcome measures: The visual analog scale digital pain or paresthesia/dysesthesia score was the primary outcome. The secondary outcomes were the Disabilities of the Arm, Shoulder, and Hand questionnaire, motor nerve conduction velocity, and cross-sectional area (CSA) of the ulnar nerve. The measurement assessment was conducted before and 1, 3, 4, and 6 months after injection.
Results: Thirty-three patients completed the study. Both injections were found to be equally effective at most measurement points, although the dextrose group experienced larger reductions in symptom severity and CSA of the ulnar nerve from the third month onward.
Conclusions: We suggest D5W as a more suitable injectate for perineural injection in patients with UNE.
This randomized, blinded, and controlled trial on hydrodissection using 5% dextrose in water (D5W) versus steroid was published in the Archived of Physical Medicine and Rehabilitation by Dr. Chen et al. in 2020.