Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

Ahmed, Ahmed M.; Hassan, Osama; Khalifa, Ahmed A.

doi:10.1186/s41983-020-00237-5

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…39 A study review recommends no significant advantage of gabapentin use for symptomatic relief or power strength improvement in mild-to-moderate CTS patients. 40 Pregabalin has been recommended as first-and/or second-line drug for neuropathic pain in several guidelines. Pregabalin is started at 150 mg daily and titrated up to the maintenance daily dose range.…”

Section: Pharmacological Managementmentioning

confidence: 99%

Current diagnosis and management of carpal tunnel syndrome: A review

Hidayati¹,

Subadi²,

Fidiana³

et al. 2022

Anaesth. pain intensive care

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Carpal tunnel syndrome (CTS) is a condition when median nerve, located in the carpal tunnel, is being suppressed by the surrounding structure. In 1854, the first clinical narration of median nerve compression in a carpal tunnel was found. CTS causes pain, tingling, and weakness in the half ring finger, middle finger, index finger, and thumb. These complaints lead the patients to seek medical help by a visiting doctor. CTS has become the major cause of upper extremity chronic neuropathic pain. CTS affects women 3.6 times more than men. This would cause high costs in medical treatment, rehabilitation, work hours lost compensation, initial pension costs, and new worker training. This makes CTS as a major problem in the field of employment. Carpal tunnel syndrome occurs as a result of chronic repetitive forceful work and other risk factors such as sex, age, heredity, hormonal, and weight. Knowledge of the diagnosis and comprehensive management of CTS are important to the doctor. Recent management based on the newest guidelines are important for clinician knowledge update. Correct diagnosis will lead to appropriate management based on recent CTS guidelines, which in turn will improve the quality of life for patients with CTS. This article will comprehensively discuss the diagnosis and recent management. Abbreviations: CTS - Carpal tunnel syndrome; NHIS - National Health Interview Study; EDX - Electrodiagnostic studies; SCT - Scratch Collapse Test; CSA - Cross-sectional area; PRP - Platelet-rich plasma; LLLT - Low-Level Laser Therapy; US – Ultrasound; DN - Dry needling; ECTR - Endoscopic carpal tunnel release; PDI - perineural dextrose injection; BCTQ - Boston Carpal Tunnel Questionnaire Key word: Carpal tunnel syndrome (CTS); neuropathy; pain; numbness; safe working environment; human; disease Citation: Hidayati HB, Subadi I, Fidiana, Puspamaniar VA. Current diagnosis and management of carpal tunnel syndrome: A review. Anaesth. pain intensive care 2022;26(3):394-404. DOI: 10.35975/apic.v26i3.1902 Received: August 16, 2021; Reviewed: April 24, 2022; Accepted: April 28, 2022

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Section: Pharmacological Managementmentioning

confidence: 99%

Current diagnosis and management of carpal tunnel syndrome: A review

Hidayati¹,

Subadi²,

Fidiana³

et al. 2022

Anaesth. pain intensive care

View full text Add to dashboard Cite

show abstract

Safety and efficacy of a modified WALANT technique using undiluted adrenaline during open surgical carpal tunnel release: a prospective report of 308 procedures

Kotb,

Omar,

Khalifa

2023

J Orthop Surg Res

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Purpose The current study aimed to report on the safety and efficacy of utilizing a modified WALANT (mWALANT) technique during open surgical carpal tunnel release (CTR), where we used undiluted epinephrine compared to the originally described WALANT technique. Methods From January 2015 till the end of June 2021, 200 patients (175 (87.5%) were females) who presented with carpal tunnel syndrome, either bilateral (108 (54%) patients) or unilateral (92 (46%)) were included, formulating a total of 308 procedures. Open surgical CTR was performed as a daycare procedure by the same surgeon. The mWALANT injectable mixture was prepared by mixing 8 CC of 2% lidocaine HCl + 1 CC of 0.25 mg/1 ml epinephrine without dilution (2.5 times the concentration used in the original WALANT technique). The injection was performed before draping. Results The patients’ average age at surgery was 42.88 ± 13.03 years old; they were followed up for an average of 31 ± 17.17 months. The average operative time was 9.5 ± 1.87 min. None (0.0%) of the patients needed top-up of local anesthesia or shift into general anesthesia, and no (0.0%) patients needed postoperative hospital stay. The average VAS during the surgical procedure was 2.5 ± 2.1, mainly reported during infiltration of the local anesthesia; no patients reported discomfort during the surgical procedure itself. 180 (90%) patients reported a full return to their usual preoperative ADL after an average of 4.7 ± 1.2 weeks. No (0.0%) postoperative fingers ischemic or temperature changes. Two (1%) patients experienced an adrenaline rush in the form of tachycardia that needed sedation and close monitoring by the anesthesiologist; they were discharged on the same day. One (0.5%) patient (who had uncontrolled diabetes mellitus) showed a superficial wound infection which resolved after conservative management. Conclusions Using undiluted epinephrine during the mWALANT technique is safe and effective. There is no need to wait until the drugs fully function, and no epinephrine-related complications were encountered apart from occasional adrenaline rush symptoms.

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Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

Cited by 2 publications

References 26 publications

Current diagnosis and management of carpal tunnel syndrome: A review

Current diagnosis and management of carpal tunnel syndrome: A review

Safety and efficacy of a modified WALANT technique using undiluted adrenaline during open surgical carpal tunnel release: a prospective report of 308 procedures

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