Pain Syndrome
Conditions
Keywords
Midazolam, median nerve, dexamethasone
Brief summary
midazolam and dexamethasone both can counteract chronic pain. either via GABA mimetic action or via anti prostaglandins
Detailed description
Entrapement syndrome - namely median nerve compression in carpal tunnel syndrome - causes chronic pain that can be refractory to medical treatment . Ultrasound guided hydrodissection is an option for alleviating pain . Recurrence is the main side effect of injection. We try in this research to prevent recurrence rate . Midazolam and dexamethasone both are used in chronic pain . Midazolm act by GABA mimetic action while dexamethasone act by decrease interleukin formation
Interventions
DRUGDexamethasone
Ultrasound guided median nerve hydrodiseection using dexamethasone or midazolam
DRUGMidazolam injection
intracarpal injection of midazolam and bupivacaine 0.5%
Sponsors
Minia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Masking description
both drugs are the same colour and volume injected by a staff member not aware of study design
Intervention model description
2 groups received hydrodissection sonar guided , one group received 50 mic/kg midazolam and the other received 8 mg dexamethasone
Eligibility
Sex/Gender
ALL
Age
30 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* numbness or pain in the nerve distribution, nerve conduction studies (NCS) corresponding with AANEM guidelines * Nerve cross sectional area \>12mm2
Exclusion criteria
* Refusal to participate * History of operation in median nerve.were patient refusal to participate, pain recurrence after previous injection and severe symptoms requiring surgical release, diabetic patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| comparing efficacy of midazolam against dexmethasone in combination with bupivacaine 0.5% | up to 6 months | use of visual analogue score |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Subjective pain assesment | up to 6 months | BOSTON questionnaire |
| complications | pain recurrence after 6 months, neurotoxicity immediately after injection | neurotoxicity, pain recurrence after injection |
| Nerve electrophysiology | up to 6 months | sensory nerve conduction , distal motor latency. |
| nerve sonogram | up to 6 months | nerve cross sectional area. |
Countries
Egypt
Outcome results
None listed