Perineural Dextrose and Corticosteroid Injections for Ulnar Neuropathy at the Elbow: A Randomized Double-blind Trial.

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.

• Authors: Liang-Cheng Chen, Tsung-Yen Ho, Yu-Ping Shen, Yu-Chi Su, Tsung-Ying Li, Chia-Kuang Tsai, Yung-Tsan Wu
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 101 Issue 8 Pg. 1296-1303 (08 2020) ISSN: 1532-821X [Electronic] United States
• PMID: 32325164 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Triamcinolone Acetonide
• Glucose

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Double-Blind Method
• Elbow
• Female
• Follow-Up Studies
• Glucose (administration & dosage, therapeutic use)
• Humans
• Injections
• Male
• Middle Aged
• Neural Conduction
• Pain (etiology)
• Pain Measurement
• Paresthesia (etiology)
• Prospective Studies
• Surveys and Questionnaires
• Triamcinolone Acetonide (administration & dosage, therapeutic use)
• Ulnar Nerve (diagnostic imaging)
• Ulnar Neuropathies (complications, drug therapy, physiopathology)
• Ultrasonography
• Upper Extremity (physiopathology)