A Randomized Controlled Trial Comparing the Efficacy of Five Percent Dextrose and Triamcinolone Hydrodissection for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is the most common entrapment neuropathy resulting from compression of the median nerve within the carpal tunnel, leading to pain, numbness, and weakness in the hand. Hydrodissection, an ultrasound guided technique, separates the median nerve from surrounding tissues to relieve compression and improve nerve mobility. This double blind randomized controlled trial aims to compare the efficacy of five percent dextrose in water and triamcinolone forty milligrams per milliliter hydrodissection in patients with mild to moderate Carpal Tunnel Syndrome. A total of 110 participants, 55 in each group, will be recruited from the Department of Physical Medicine and Rehabilitation at the All India Institute of Medical Sciences, Jodhpur. Group A will receive a 10 milliliter injectate of five percent dextrose in water, consisting of 2 milliliters of 25 percent dextrose, 3 milliliters of two percent lidocaine, and 5 milliliters of normal saline. Group B will receive 10 milliliters of triamcinolone preparation, consisting of 1 milliliter triamcinolone, 3 milliliters of two percent lidocaine, and 6 milliliters of normal saline. Injections will be performed under ultrasound guidance using an in plane ulnar approach. Outcomes including pain score using visual analog scale, Boston Carpal Tunnel Syndrome Questionnaire, ultrasound measured cross sectional area, nerve conduction studies, and grip strength will be assessed at baseline, 1 month, and 3 months. Five percent dextrose in water hydrodissection is hypothesized to provide longer lasting pain relief and functional improvement compared to triamcinolone.