Evaluation of the effectiveness of local Dexamethasone injection in pregnant women with carpal tunnel syndrome

Abstract

• Background: Most medical treatments for carpal tunnel syndrome (CTS) have focused on suppressing the inflammatory process. Injection of dexamethasone acetate might provide the necessary cellular and humoral mediators to induce a healing cascade. Dexamethasone is a water-soluble steroid that is safe to be used in the third trimester, especially as a local treatment. The aim of this study was to evaluate the effectiveness of 4 mg dexamethasone acetate injection for treatment of carpal tunnel syndrome in pregnancy period.
• Methods: Twenty pregnant patients with carpal tunnel syndrome were recruited using strict inclusion and exclusion criteria. All patients were injected with 4 mg of Dexamethasone acetate and 0.5 ml lidocaeine 1% under the carpal tunnel. Pain intensity [based on visual analog scale (VAS)] and electrophysiologic parameters of median nerve (transcarpal median sensory nerve conduction velocity (SNCV), distal motor latency (DML), and distal sensory latency (DSL) were recorded before and 3 weeks after injection.
• Results: The average pain scores before and 3 weeks after Dexamethasone acetate injection was 8.70 ± 0.92 and 4.30 ± 0.76 respectively (p < 0.005). Also transcarpal sensory nerve conduction velocity of median nerve was 33.7 ± 6.3 m/s and 24.5 ± 6.8 m/s (p = 0.001); distal motor latency of median nerve was 5.16 ± 1.04 ms and 4.70 ± 0.53 ms (p = 0.001) and distal sensory latency of median nerve was 4.84 ± 0.77 ms and 4.2 ± 0.6 ms (p = 0.001), respectively.
• Conclusions: After Dexamethasone acetate injection, pain intensity and electerophysiologic parameters were significantly improved. This study offers encouraging results for an alternative minimally invasive treatment for CTS in pregnant women.
• Keywords: Dexamethasone Acetate Injection, Carpal Tunnel Syndrome, Pain Intensity, Electrophysiologic Parameters.