Comparison of Ultrasound-Guided Hydrodissection with Various Volumes of 5% Dextrose for Carpal Tunnel Syndrome: A Prospective Randomized Controlled Double-Blind Trial

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OBJECTIVE: Ideal volume of 5% dextrose for median nerve hydrodissection for treating carpal tunnel syndrome is still unknown. This study assessed the efficacy of nerve hydrodissection using varying volumes of 5% dextrose for treating mild to moderate carpal tunnel syndrome. DESIGN: Eighty participants with unilateral mild to moderate carpal tunnel syndrome were randomized into groups to receive either 5 ml of normal saline, 5 ml of 5% dextrose, 10 ml of normal saline, and 10 ml of 5% dextrose, with each group undergoing one session of ultrasound-guided hydrodissection. Visual analog scale, Boston Carpal Tunnel Syndrome Questionnaire, grip and pinch strength, cross-sectional area of median nerve, and electrophysiological assessment were performed at baseline and weeks 4 and 12. RESULTS: In the 10 ml 5% dextrose group, visual analog scale scores considerably improved compared with those in the normal saline groups. Although nerve cross-sectional area values decreased in all groups during follow-ups, the 10 ml 5% dextrose group showed a statistically significant improvement compared to the normal saline groups by the 12th week ( P ≤ 0.01). CONCLUSIONS: Ultrasound-guided median nerve hydrodissection with 10 ml 5% dextrose was more effective in reducing pain and nerve size than the normal saline groups at the 12th week.