Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial

Egyptian Journal of Anaesthesia

Mohammad Awad Alsaeed¹  Mina Maher Raouf²  Emad Zarief Kamel³  Tamer Elzaem Esmael⁴  Esraa A Talaat⁵  Manal Hassanien⁵ 

[1] Anesthesia, intensive care and pain management department, Faculty of Medicine, Fayoum University, Fayoum, Egypt;Anesthesia, intensive care and pain management department, Faculty of Medicine, Minia University, Minia, Egypt;Anesthesia, intensive care, and pain management department, Faculty of Medicine, Assiut University, Assiut, Egypt;Radiodiagnosis and intervention radiology department, Faculty of Medicine, Minia University, Minia, Egypt;Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt;

关键词: Carpal tunnel syndrome;    pain;    neuralgia;    carpal tunnel syndrome questionnaire;    dexamethasone;    midazolam;   

DOI  :  10.1080/11101849.2022.2059612

来源: DOAJ

【 摘 要 】

Background Intracarpal injection of steroids has produced favorable effects in patients with carpal tunnel syndrome (CTS); however, it still carries some drawbacks. Perineural midazolam injection has some promising effects in chronic neuralgia. This study focused upon pain visual analog scale (VAS) improvement, and Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) improvements when comparing intracarpal injection of midazolam versus dexamethasone.Methods One hundred and thirty-four patients with mild to moderate CTS were randomized (1:1 ratio) to receive intracarpal 3 ml bupivacaine 0.5% with either 8 mg dexamethasone in 2 ml saline (group DX) or 2 mg midazolam in 2 ml saline (group MZ). VAS and BCTQ were assessed preintervention and postintervention (1st week, 1st, 3rd, and 6th months)Results The VAS showed a significantly lower value in MZ than the DX group with median value of 2 (maximum-minimum = 1–3) in MZ and 4 (2–5) in DX by the 6th month p = 0.049. Intragroup comparison of follow-up VAS to the baseline value showed significant decreases in the MZ group during the whole study period, whereas in DX the decrease was noticed by the 1st week and 1st month only. In postinterventional BCTQ, both symptom severity (SSS) and functional severity (FSS) scores were significantly lower in MZ rather than DX group after the 1st, 3rd, and 6thmonths where SSS (p = 0.029, 0.048, 0.04) and FSS (p = 0.04, 0.019, 0.003) in consequence.Conclusions Intracarpal injection of midazolam offers a longer duration of pain relief and higher hand functional improvement scores in comparison to dexamethasone.

【 授权许可】

Unknown