Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial
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)...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2059612 |
| _version_ | 1811311633482383360 |
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| author | Mina Maher Raouf Mohammad Awad Alsaeed Manal Hassanien Esraa A Talaat Tamer Elzaem Esmael Emad Zarief Kamel |
| author_facet | Mina Maher Raouf Mohammad Awad Alsaeed Manal Hassanien Esraa A Talaat Tamer Elzaem Esmael Emad Zarief Kamel |
| author_sort | Mina Maher Raouf |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T10:22:14Z |
| format | Article |
| id | doaj.art-bf7f241f83934e16ae3b6796038227d2 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-13T10:22:14Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-bf7f241f83934e16ae3b6796038227d22022-12-22T02:50:28ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138118519210.1080/11101849.2022.2059612Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trialMina Maher Raouf0Mohammad Awad Alsaeed1Manal Hassanien2Esraa A Talaat3Tamer Elzaem Esmael4Emad Zarief Kamel5Anesthesia, intensive care and pain management department, Faculty of Medicine, Minia University, Minia, EgyptAnesthesia, intensive care and pain management department, Faculty of Medicine, Fayoum University, Fayoum, EgyptRheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, EgyptRheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, EgyptRadiodiagnosis and intervention radiology department, Faculty of Medicine, Minia University, Minia, EgyptAnesthesia, intensive care, and pain management department, Faculty of Medicine, Assiut University, Assiut, EgyptBackground 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.https://www.tandfonline.com/doi/10.1080/11101849.2022.2059612Carpal tunnel syndromepainneuralgiacarpal tunnel syndrome questionnairedexamethasonemidazolam |
| spellingShingle | Mina Maher Raouf Mohammad Awad Alsaeed Manal Hassanien Esraa A Talaat Tamer Elzaem Esmael Emad Zarief Kamel 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 Carpal tunnel syndrome pain neuralgia carpal tunnel syndrome questionnaire dexamethasone midazolam |
| title | Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial |
| title_full | Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial |
| title_fullStr | Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial |
| title_full_unstemmed | Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial |
| title_short | Intracarpal midazolam: does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients? A randomized double-blind clinical trial |
| title_sort | intracarpal midazolam does it offer better pain relief than dexamethasone in carpal tunnel syndrome patients a randomized double blind clinical trial |
| topic | Carpal tunnel syndrome pain neuralgia carpal tunnel syndrome questionnaire dexamethasone midazolam |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2059612 |
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