The Ef(cid:976)icacy of Dexamethasone Sodium Phosphate
Compared to Triamcinolone Acetonide in the Treatment
of Carpal Tunnel Syndrome: A Randomized Double-Blind
Controlled Trial
Thitinut Dilokhuttakarn MD1, Sasipong Lertnantapanya MD1, Sorasakdi Vechmamontien MD1,
Chawin Suwanchatchai MD2
Affiliation :
1 Department of Orthopedics, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
2 Department of Community Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Background : Corticosteroid injections have been used in carpal tunnel syndrome (CTS). However, there have been reported side
effects associated with the drugs. Dexamethasone sodium phosphate has been studied to cause fewer side effects and the least
neurotoxic agent. However, evidence of the ef(cid:976)icacy of dexamethasone sodium phosphate in CTS is still lacking.
Objective : To compare the ef(cid:976)icacy of dexamethasone sodium phosphate and triamcinolone acetonide in the treatment of CTS and
observe their complications.
Materials and Methods: A prospective randomized double-blind controlled trial study was performed between January and
December 2015 at HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University in Nakhon Nayok province.
Patients with CTS were randomly assigned into two groups based on the mode of treatment with either dexamethasone sodium
phosphate or triamcinolone acetonide. Results of treatment were measured via hand grip power, positive Phalen’s test time, Global
Symptom Score for Carpal Tunnel Syndrome (GSS), Disability of Arm, Shoulder, and Hand Questionnaire (DASH) score. Negative
outcome in patients that required surgery and the complications were also recorded.
Results : Sixty patients with CTS were randomly assigned into two groups [dexamethasone sodium phosphate group (n = 30) and
triamcinolone acetonide group (n = 30)]. There was no difference of demographic data between the two groups. The dexamethasone
sodium phosphate group improved signi(cid:976)icantly in positive Phalen’s test time (mean difference -5.53; 95% con(cid:976)idence interval
-0.56 to -10.50, p=0.029). In other measurement, the dexamethasone sodium phosphate group had better scores and had a lower
number of patients who required and underwent surgery, but there was no signi(cid:976)icant difference between the two groups (p>0.05).
No serious complication was detected at the time of follow-up.
Conclusion : In the treatment of CTS by corticosteroid injection, dexamethasone sodium phosphate was effective and improved
signi(cid:976)icantly in positive Phalen’s test time, compared to those treated with triamcinolone acetonide, which was widely prescribed.
No serious complication was detected in either groups.
Keywords : Carpal tunnel syndrome, Steroid injection, Corticosteroid
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