aDjunct bicarbonatE in Local anaesthesIa for CarpAl Tunnel rElease (DELICATE)
Carpal Tunnel SyndromeIntroduction Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment syndrome in Finland and worldwide. Nowadays carpal tunnel release (CTR) surgery is often done in local anaesthesia. Often the most painful event during CTR is the injection of the local anaesthetic. Multiple different methods have been trialed and buffering the local anaesthetic seems to have good results in reducing the pain caused by the injection. However, no study has buffered long-acting local anaesthetic in CTR surgery, and no study has accounted for the patient's individual pain tolerance in the groups. There are no comparisons of the results to minimal clinically important difference (MCID) for pain. Hypothesis In this study the investigators will evaluate the effects of buffering long-lasting local anaesthetic in wide-awake local anaesthesia no tourniquet (WALANT) CTR. This study's hypothesis is that buffering long-acting local anaesthetic with sodium bicarbonate decreases the pain of the injection. The investigators also expect that buffering will reduce the number of needle stings felt during injection, will result in as good perioperative pain control, will lengthen the effect of anaesthetic, will reduce postoperative painkiller usage, will have at least as good functional outcome and greater patient satisfaction. Methods This study will enlist 116 patients and divide the patients into two groups in this double blinded randomized controlled trial. One group receives non-buffered, and the second group buffered local anaesthetic. This study's primary outcome is to compare burning, pressure, needle sting and total pain the patient experienced between the groups. The investigators will assess this using VAS, and will compare the results to MCID. The investigators secondary outcomes are comparisons of expected injection pain level and pain during CTR with VAS, individual pain tolerance/catastrophising tendency with preoperative PCS-FINv2.0 form, the number of needle stings the patient feels during the injection, functional outcome and improvement of the patients' symptoms with The Boston Carpal Tunnel Questionnaire (Likert 5) before and after the surgery, evaluation of patient satisfaction with net promoter score (NPS) and the use of painkillers, duration of analgesia and pain levels using VAS after the surgery until the 3rd postoperative night.
Effect of Different Doses of US in the Treatment of CTS
Carpal Tunnel SyndromeThe purpose of this study will be to investigate the effective dose of therapeutic ultrasound in the treatment of carpal tunnel syndrome on pain level, functional ability, motor and sensory nerve conduction parameters and pinch strength.
Soft Tissue Massage Along With Mobilization Technique on Symptoms and Functional Status of Carpal...
Carpal Tunnel SyndromeThe objective of this experimental study is to determine the effect of soft tissue massage along with mobilization technique on intensity of pain by visual analog scale and functional status by using Jamar hand-held dynamometer, Pinch Gauge and Boston Scale for carpal tunnel syndrome questionnaire in Carpal tunnel syndrome patients. It is being conducted on patients with Carpal tunnel syndrome at Sindh Institute of Physical Medicine and Rehabilitation, Karachi and Neurological outpatient department of Dr. Ruth K. M. Pfau, Civil Hospital Karachi among Sixty participants with mild and moderate severity of Carpal Tunnel Syndrome will be randomly allocated in two groups after initial screening by a consultant physiatrist according to CTS-6 scale. Written informed consent will be taken from each participant. Group A will be treated with soft tissue massage (Medenci hand massage technique) along with joint (radiocarpal and inter-carpal) and median nerve mobilization slider technique while group B will be treated with joint (radiocarpal and inter-carpal) and median nerve mobilization slider technique only. Participant will be evaluated by visual analog pain scale, Boston scale of carpal tunnel syndrome, dynamometer and -pinch gauge, Center for Epidemiologic Studies Depression Scale and Pain Anxiety Symptoms Scale on day 1 and last treatment session.
Evaluation of a Conservative Treatment by Nocturnal Wrist Orthosis in the Non-surgical Management...
Carpal Tunnel SyndromeThis study focuses on the evaluation of 2 nocturnal wrist orthosis prescribed as part of a non-surgical management of carpal tunnel syndrome in order to determine their effectiveness in reducing the symptoms associated with the syndrome and to highlight the superiority or the inferiority of one over the other. It will also be possible to assess their comfort and compliance as well as the impact of wearing them on neurological and muscular recovery (functional assessment).
Efficacy of Median Nerve Hydrodissection by Hyalase Versus Midazolam in the Treatment of Carpal...
PainNeuropathicComparing efficacy of hyalase and midazolam in median nerve entrapement neuropathy
BotulInum Toxin Type A for Peripheral Neuropathic Pain in subjEcts With Carpal Tunnel Syndrome
Carpal Tunnel SyndromeNeurogenic Inflammation3 moreThe main purpose of the study is to assess the safety and efficacy of repeated administrations of BoNT-A in subjects with NP attributable to carpal tunnel syndrome (CTS) through a randomized, double-blind, placebo-controlled study. Further research has shown that BoNT-A has analgesic properties independently from its action on muscle tone, possibly by acting on neurogenic inflammation. Therefore, the study drug may be better than other treatments surgical or non-surgical currently available for the treatment of CTS.
Ultrasound-guided Dextrose Injection Versus Dextrose With Methylprednisolone in Carpal Tunnel Syndrome...
Carpal Tunnel SyndromeThe goal of this prospective, randomized, double-blinded, head-to-head comparative study is to compare the efficacy of ultrasound-guided 4 ml 5% dextrose perineural injection versus 3 ml 5% dextrose with 1 ml 40 mg/ml methylprednisolone perineural injection in patients with carpal tunnel syndrome (CTS). The main questions it aims to answer are: Is there a difference in efficacy between interventions regarding 1. pain alleviation, 2. improvement in symptoms severity and functional status, 3. improvement in grip strength, 4. size of median nerve cross-sectional area, and 5. improvement in quality of life during the six-month post-intervention follow-up period?
Wound Closure Study in Carpal Tunnel and Trigger Finger Surgery
Carpal Tunnel SyndromeTrigger FingerDoes a difference in patient satisfaction and cosmetic outcome exist between wound closure with absorbable or non-absorbable sutures.
Neurodynamic Sequencing in Patients With Carpal Tunnel Syndrome
Carpal Tunnel SyndromeCarpal tunnel syndrome is a compressive neuropathy of median nerve in the fascial tunnel at wrist which causes pain, numbness ,and tingling in the extremities. Common treatment options used in the treatment of carpal tunnel syndrome are conservative and surgical treatment option is better, this question is still a topic requiring more and more clinical trials. Neuromobilisation described by Butler is one of the treatment options which are used in the treatment of carpal tunnel syndrome in conjunction with other conservative measures. This proposed study will find out the effectiveness of Neuromobilisation in treatment of carpal tunnel syndrome. As there is very little evidence available which Neuromobilisation technique is effective and what are the types of patients which can get benefit from this technique. This study will find out the effect of Neuromobilisation in patients suffering from carpal tunnel syndrome of non traumatic origin. This is a randomized clinical trial. Target population is patients suffering from carpal tunnel syndrome of non-traumatic origin. Data will be collected from District Headquarter Hospital Faisalabad. This study will include 56 participants according to the selection criteria. The participants will be randomly divided into two groups through sealed opaque envelop method. Group A will recruit 28 patients which fulfill the inclusion criteria. These patients will be treated by nerve sequencing proximal to distal in 3 sets of 15 repetitions in one session on alternate days for 4 weeks. Group B will recruit 28 patients which fulfill the inclusion criteria. These patients will be treated by nerve sequencing distal to proximal in 3 sets of 10 repetitions in one session for 4 weeks. The Statistical analysis will be performed through SPSS Software 21.
Efficacy of EPSW Plus HILT on Carpal Tunnel Syndrome Post Burn Injury
Burn InjuryTo study the effect of adding ESWT as a noninvasive short-term treatment plus high-level laser therapy for moderate carpal-tunnel syndrome post-burn injuries.