Dernek Bahar, Aydin Tugba, Koseoglu Pinar Kursuz, Kesiktas Fatma Nur, Yesilyurt Tugba, Diracoglu Demirhan, Aksoy Cihan
Physical Therapy and Rehabilitation Clinic, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
Physical Therapy and Rehabilitation Clinic, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
J Back Musculoskelet Rehabil. 2017;30(3):435-440. doi: 10.3233/BMR-150477.
Carpal tunnel syndrome (CTS) is a commonly seen peripheral nerve mononeuropathy. Corticosteroid injection within the carpal tunnel is among the conservative treatment options. The exact mechanism of action of steroids is not fully clear; decreased inflammation surrounding nerves or tendons is thought to be the main effect. Lidocaine has been shown to have anti-inflammatory effects on certain cells (monocytes, macrophages, neutrophils etc.). The aim of this study is to evaulate the efficacy of lidocaine treatment as a alternative to corticosteroid treatment in carpal tunnel syndrome.
A total of 67 carpal tunnel syndrome patients who were diagnosed with physical examination and EMG were evaluated. Twenty-nine patients received a mixture of normal saline solution and lidocaine (0.5 cc of normal saline solution and 0.5 cc of lidocaine) while 38 patients were administered betamethasone dipropionate (1 cc). Quick DASH (Disabilities of the Arm, Shoulder and Hand) and Visual Analog Scale (VAS) scores were noted in 1st, 3rd and 6th month follow-ups.
There were no significant difference between saline solution + Lidocaine group and betamethasone dipropionate groups; initial, 1st, 3rd and 6th month VAS scores and QDASH scores (p > 0.05).
Considering the potential side effects of corticosteroid, lidocaine injection is a good alternative treatment of carpal tunnel syndrome instead of corticosteroids.
腕管综合征（CTS）是一种常见的周围神经单神经病。腕管内注射皮质类固醇是保守治疗选择之一。类固醇的确切作用机制尚不完全清楚；神经或肌腱周围炎症减轻被认为是主要作用。利多卡因已被证明对某些细胞（单核细胞、巨噬细胞、中性粒细胞等）具有抗炎作用。本研究的目的是评估利多卡因治疗作为腕管综合征皮质类固醇治疗替代方法的疗效。
对67例经体格检查和肌电图诊断为腕管综合征的患者进行评估。29例患者接受生理盐水和利多卡因混合液（0.5毫升生理盐水和0.5毫升利多卡因），而38例患者给予二丙酸倍他米松（1毫升）。在第1、3和6个月随访时记录快速DASH（手臂、肩部和手部功能障碍）和视觉模拟量表（VAS）评分。
生理盐水+利多卡因组和二丙酸倍他米松组之间无显著差异；初始、第1、3和6个月的VAS评分和QDASH评分（p>0.05）。
考虑到皮质类固醇的潜在副作用，利多卡因注射是替代皮质类固醇治疗腕管综合征的一种良好的替代治疗方法。
