[Comparison of effect of EMLA cream and injection of methyl prednisolone acetate relief of pain associated with carpal tunnel syndrome]

A standard treatment option for carpal tunnel syndrome [CTS] is local injection of anesthetic-corticosteroid. This clinical trial was designed to compare the safety and efficacy of daily application of the EMLA cream with that of a single injection of methyl prednisolone acetate. This is a clinical trial which was performed in the clinics of Shiraz medical school in 1386. Sixty five participants with clinical and electrodiagnostic evidence of mild to moderate CTS were randomized to receive either the EMLA cream [group 1] or one injection [40 mg] of methylprednisolone acetate at wrist [group 2]. Visual analog scale was used to assess the patients' pain acuity. Collected data were statistically analyzed by SPSS software using Chi-Square test. Pain intensity before and after treatment and also 4 weeks after treatment in group A was 5.8 +/- 0.98, 0.7 +/- 0.82 and 2.1 +/- 1.2 and 5.7 +/- 1, 2.4 +/- 1.5 and 1.6 +/- 1.4 in group B. The differences in pain intensity in both group were significant [p<0.001]. EMLA cream was effective in reducing pain associated with CTS. It can be an effective, noninvasive symptomatic treatment for the patients with mild to moderate CTS

Sympathetic skin response in patients with carpal tunnel syndrome

Median nerve entrapment in the wrist is the most common entrapment neuropathy and is called carpal tunnel syndrome [CTS]. Conventional electrophysiologic studies evaluate only the myelinated fibers. Sympathetic skin response [SSR] is a wellestablished test for evaluation of the unmyelinated sympathetic fibers. This study was designed to evaluate the sympathetic fibers in CTS. Fifty four patients with carpal tunnel syndrome and 78 healthy subjects were enrolled in this study. Conventional electrodiangostic studies and SSR were performed in all the subjects with standard method. Latency of the SSR in healty subjects was 1520.21 +/- 87.25 ms and 1637.11 +/- 281.13ms in patients. Unmyelinated sympathetic fibers are involved in CTS and SSR which may, along with other conventional electrophysiologic tests, help in diagnosis of CTS