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midazolam and dexamethasone both can counteract chronic pain. either via GABA mimetic action or via anti prostaglandins
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
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| dexamethasone group | Active Comparator | sonar guided median nerve hydrodissection by bupivacaine 0.5% and dexamethasone |
|
| midazolam group | Active Comparator | sonar guided median nerve hydrodissection by bupivacaine 0.5% and midazolam |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexamethasone | Drug | Ultrasound guided median nerve hydrodiseection using dexamethasone or midazolam |
|
| Measure | Description | Time Frame |
|---|---|---|
| comparing efficacy of midazolam against dexmethasone in combination with bupivacaine 0.5% | use of visual analogue score | up to 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Subjective pain assesment | BOSTON questionnaire | up to 6 months |
| complications | neurotoxicity, pain recurrence after injection | pain recurrence after 6 months, neurotoxicity immediately after injection |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mina Maher Raouf | ALMinya | Egypt | 6115 | Egypt |
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2 groups received hydrodissection sonar guided , one group received 50 mic/kg midazolam and the other received 8 mg dexamethasone
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both drugs are the same colour and volume injected by a staff member not aware of study design
| Midazolam injection | Drug | intracarpal injection of midazolam and bupivacaine 0.5% |
|
| Nerve electrophysiology | sensory nerve conduction , distal motor latency. | up to 6 months |
| nerve sonogram | nerve cross sectional area. | up to 6 months |
| ID | Term |
|---|---|
| D013001 | Somatoform Disorders |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D003907 | Dexamethasone |
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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