PENGARUH INJEKSI STEROID LOKAL TERHADAP LATENSI DISTAL SENSORIK DAN MOTORIK PADA SINDROM TEROWONGAN KARPAL

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Daniel Setiawan Wanahardja ◽  
Andi Kurnia Bintang ◽  
Yudy Goysal
Keyword(s):  
Social Sciences ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Oral Steroid ◽  
Motor Latency ◽  
Tunnel Syndrome ◽  
Local Steroid Injection ◽  
And Control ◽  
Sensory Latency

  THE EFFECT OF LOCAL STEROID INJECTION ON DISTAL SENSORY AND MOTOR LATENCY IN PATIENTS WITH CARPAL TUNNEL SYNDROMEABSTRACTIntroduction: Carpal tunnel syndrome (CTS) is the most common type of neuropathy found in upper extremities. The syndrome can cause disability and leads to the decrease in productivity. Local steroid injection can help alleviate the symptoms, delay operation, and improve electrophysiologic parameter in a concise period.Aims: To determine the effect of steroid injection on distal sensory and motor latency in patients with CTS.Methods: Clinical trial with non-randomized paralel group design on patients in dr. Wahidin Sudirohusodo Hospi- tal from March to August 2017. Patients were divided into two groups, treatment group who were injected with intracanal steroid (n=20) and control who were treated with oral steroid (n=20). Electroneuromyography (ENMG) evaluation was done on the first day and one week after steroid injection. Statistical analysis was done with Statistical Packages for Social Sciences (SPSS) version 22. Wilcoxon sign-ranked and Mann-Whitney U test were used to analyze the difference between the treatment and control groups.Results: Distal sensory and motor latency improved significantly in both groups. Distal sensory latency after steroid were improved in both groups. But the improvement was more significant in steroid injection group compared to control group in sensory (0,30mSec vs 0,06mSec), and also motor distal latency (0,53mSec vs 0,09mSec).Discussion: Steroid injection improves distal sensory dan motor latency in patients with carpal tunnel syndrome.Keywords: Carpal tunnel syndrome, distal motor latency, distal sensory latency, steroid injectionABSTRAKPendahuluan: Sindrom terowongan karpal (STK) adalah jenis neuropati yang paling sering terjadi pada ekstremi- tas atas. Sindrom ini menyebabkan disabilitas dan menurunkan produktivitas. Injeksi steroid lokal (intrakanal) dapat mer- ingankan gejala, menunda operasi, dan memperbaiki parameter elektrofisiologi dalam jangka pendek.Tujuan: Mengetahui pengaruh injeksi steroid terhadap latensi distal sensorik dan motorik pada pasien dengan STK.Metode: Uji klinis dengan desain grup paralel terhadap pasien dengan STK yang berobat di RSUP Dr. Wahidin Sudirohusodo dari bulan Maret hingga Agustus 2017. Subjek dibagi menjadi kelompok perlakuan yang diberi injeksi ste- roid (lokal) intrakanal (n=20) dan kelompok kontrol yang diberikan steroid oral (n=20). Pemeriksaan elektroneuromiografi (ENMG) dilakukan pada hari pertama subjek datang ke RS dan satu minggu pascaterapi steroid. Analisis statistik dilaku- kan dengan program Statistical Packages for Social Sciences (SPSS) versi 22. Uji Wilcoxon signed-rank dan Mann-Whitney U digunakan untuk meneliti hubungan antar kelompok injeksi steroid lokal dan oral.Hasil: Terdapat pemendekan latensi distal sensorik dan motorik secara signifikan pasca pemberian steroid pada kedua kelompok. Namun pemendekan tersebut terjadi lebih besar dan lebih signifikan pada kelompok injeksi steroid lokal dibandingkan oral, baik pada latensi distal sensorik (0,30mdet vs 0,06mdet), maupun pada latensi distal motorik (0,53mdet vs 0,09mdet).Diskusi: Injeksi steroid intrakanal memperpendek latensi distal sensorik dan motorik pada pasien dengan sindrom terowongan karpal secara bermakna.Kata kunci: Injeksi steroid, latensi distal motorik, latensi distal sensorik, sindrom terowongan karpal

scholarly journals Efficacy of Local Corticosteroid in Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial

2013 ◽  
Vol 28 (1) ◽  
pp. 10-15
Author(s):  
Anis Ahmed ◽  
Md Rafiqul Islam ◽  
Hasan Zahidur Rahman ◽  
Md Moniruzzaman Bhuiyan ◽  
Sukumar Majumder ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Oral Steroid ◽  
Steroid Group ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Local Steroid Injection

Background: Carpal tunnel syndrome (CTS) is a common health problem in Bangladesh especially among women. It causes significant morbidity and reduces work output in affected patients. There are few treatment options available like oral steroid, steroid injection, UST, surgical treatment etc. Considering the cost, time and consequence of surgery, short term nonsurgical management is desirable e.g. local steroid injection in the affected limb. Therefore a comparative analysis is necessary to understand the efficacy of local steroid injection.Objective: To evaluate the efficacy of local corticosteroid injection in the treatment of idiopathic carpal tunnel syndrome. Methods: 60 idiopathic CTS patients divided into two groups by randomization. One group received Inj. Triamcinolone 30 mg close to carpal tunnel and other group received oral steroids. Efficacies of treatmemt were compared in between groups.Result: The mean age of two groups were 37.5 ± 10.5 and 37.0 ± 10.24 years respectively (p = 0.272) and Majority of the patients in both treatment groups (76.7% in local steroid and 80% in oral steroid groups, p = 0.754) were female. Relief from tingling sensation and nocturnal awakening was higher in the steroid injection receivers (100% and 86.7% respectively) than that in the oral steroid receivers (6.9% and 3.4% respectively) during evaluation of outcome at the end of 3 month. End point treatment shows that none but SNAP at wrist in the local steroid group improved significantly better than that in the oral steroid group (16.2 ± 10.5 vs. 12.4 ± 6.3, p =0.039). No major side effects occurred in local steroid group except depigmentation in injected area 3 (10%) cases.Conclusion: It may be concluded that local steroid injection is an effective treatment of idiopathic carpal tunnel syndrome. But long-term efficacy of steroid injection remains uncertain.Bangladesh Journal of Neuroscience 2012; Vol. 28 (1): 10-15

scholarly journals Anatomical Basis of Ulnar Approach in Carpal Tunnel Injection

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. E191-E198
Author(s):  
Dr. Dong Hwee Kim
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Ulnar Artery ◽  
Injection Technique ◽  
Anatomical Basis ◽  
Number Of Patients ◽  
Tunnel Syndrome ◽  
Local Steroid Injection

Background: Local steroid injection may be an effective conservative treatment for carpal tunnel syndrome; however, the use of a blind injection technique can increase the chance of median nerve or ulnar artery injury due to median nerve swelling or the close proximity of the median nerve and ulnar artery around the distal wrist crease. Objectives: The purpose of this study is to investigate the relative location of the median nerve and ulnar artery to the palmaris longus (PL) tendon around the wrist in carpal tunnel syndrome. Study Design: An observational study. Setting: A university outpatient interventional pain management practice in the Republic of Korea. Methods: Thirty hands of 15 patients with carpal tunnel syndrome and 30 hands of 15 healthy subjects were studied. Ultrasonography was performed to determine the relative relationship of the ulnar artery and median nerve to the PL tendon around the wrist. Results: There were statistically significant differences both in the distance from the medial margin of the PL to the medial end of the median nerve and the distance from the medial end of the median nerve to the lateral end of the ulnar artery at all levels of scanning between the 2 groups. Limitations: Limitations include the inclusion of a small number of patients with carpal tunnel syndrome. Conclusion: It is important to recognize the risk of blind local steroid injection for carpal tunnel syndrome, which is most likely a result of swelling and/or flattening of the median nerve around the distal wrist crease. A real time, ultrasound-guided local steroid injection is preferred as a safe and accurate technique in carpal tunnel syndrome treatment. Key Words: Carpal tunnel syndrome, median nerve, ulnar artery, injection, steroid, injury, ultrasonography, risk, cross-sectional area

scholarly journals Evaluation of Local Corticosteroids Injection in Treatment of Carpal Tunnel Syndrome

2021 ◽  
pp. 21-27
Author(s):  
Mostafa Fersan Sallam ◽  
Nabil Omar Gharbo ◽  
Muhammed Abd Elmoneam Quolquela ◽  
Mohammed Osama Ramadan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Dominant Hand ◽  
University Hospitals ◽  
Significant Clinical Improvement ◽  
Tunnel Syndrome ◽  
Local Steroid Injection ◽  
A Prospective Study ◽  
Symptoms And Signs

Background: Carpal tunnel syndrome is the most common type of peripheral nerve entrapment; it affects females more than males; it may be idiopathic or secondary to other disorders especially diabetes mellitus. Carpal tunnel syndrome mostly affects manual workers and may be bilateral or unilateral and mainly affects the dominant hand. Carpal tunnel syndrome has characteristic symptoms and signs including paresthesia and pain along median nerve distribution, these symptoms are usually accompanied by positive provocative tests. Electrodiagnostic studies remain the cornerstone in the diagnosis of CTS. Carpal tunnel syndrome can be treated conservatively by activities of daily living instructions, splints, medical treatments as neurotropic drugs and NSAIDs and local steroid injection. Also, it can be treated by surgical decompression in severe cases. Aims: The aim of this study was to evaluate local steroid injection in the treatment of CTS. Twenty-one patients with mild and moderate CTS were included in this study. Patients and Methods: This was a prospective study included 21 patients with symptoms and signs of mild to moderate CTS attending the outpatient clinic of orthopedic Department, Tanta University Hospitals in the period between February 2019- January 2020. 1 ml Triamcinolone was used with 2 ml lidocaine. Patient’ hand was rested on towel roll flexed about 30 to 45 degrees and injection was done according to landmarks. Night splint was described for 3 days after injection. Results: In regards to clinical assessment; there was a significant clinical improvement after injection and follow-up period as compared to before injection. In regards to electrophysiological assessment; there was a significant improvement in NCS after injection. Conclusion: Local steroid injection is an effective treatment and recommended as a therapeutic tool in the management of idiopathic mild to moderate CTS.

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