Intradermal Therapy (Mesotherapy) for the Treatment of Acute Pain in Carpal Tunnel Syndrome: A Preliminary Study

BACKGROUND: The carpal tunnel syndrome (CTS) is the most common cause of severe hand pain. In this study we treated acute pain in CTS patients by means of local intradermal injections of anti-inflammatory drugs (mesotherapy). METHODS: In twenty-five patients (forty-five hands), CTS diagnosis was confirmed by clinical and neurophysiological examination prior to mesotherapy. A mixture containing lidocaine 10 mg, ketoprophen lysine-acetylsalycilate 80 mg, xantinol nicotinate 100 mg, cyanocobalamine 1,000 mcg plus injectable water was used. Sites of injection were three parallel lines above the transverse carpal ligament and two v-shaped lines, one at the base of the thenar eminence, and the other at the base of the hypothenar eminence. RESULTS: The day after the treatment, all but four patients reported a significant reduction in pain and paresthesias. After 12 months, 17 patients had a complete pain relief, eight patients reported recurrence of pain and sensory symptoms and four out of them underwent surgical treatment. CONCLUSIONS: With the obvious limits of a small-size open-label study, our results suggest that mesotherapy can temporary relieve pain and paresthesias in most CTS patients and in some cases its effect seems to be long-lasting. Further controlled studies are needed to confirm our preliminary findings and to compare mesotherapy to conventional approaches for the treatment of CTS.

The role of xanthine oxidase and the effects of antioxidants in ischemia reperfusion cell injury

During last years considerable interest has been devoted to understand the role of oxugen radicals in the inschemia induced cell injury associated with reperfusion. In the brain and in others tissues, free radicals play a role as modulators of vascular tone as well as a cytotoxic role as part of the ischemia associated pathology. This review discusses methods for free radical detection in brain and in other tissues, mechanisms of radical production in the course of the ischemia reperfusion process, and the efficacy of potential antioxidant agents in post ischemia therapy, especially with respect to allopurinol, an inhibitor of xanthine oxidase, and the role of taurine and its derivatives as antioxidants in different organs including the brain.

Role of xanthinol nicotinate in the revival of monkeys subjected to acute haemorrhagic shock.

The therapeutic potential of xanthinol nicotinate in the revival of anaesthetised monkeys subjected to acute blood loss was investigated. The arterial pressure was lowered to 40 +/- 5 mmHg by rapid arterial bleeding and was maintained at this level for 2 h. Shed blood was then returned through infusion, to the animals. Animals alive at the end of 72 h observation period were considered as survivors. The test drug was infused 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. The animals which received normal saline instead of test drug were treated as control. The physiological and biochemical parameters recorded prior to and after the onset of oligaemic hypotension were heart rate, pulse pressure, electrocardiogram, electroencephalogram (EEG), lactic acid, creatine phosphokinase, urea and glucose. The results showed tachycardia, narrowing of pulse pressure, depression of ST segment with occasional T inversion, slowing of EEG with increase in amplitude, rise in blood lactic acid, creatine phosphokinase, urea and glucose. The magnitude of these responses were proportional to the duration and severity of shock. These changes were markedly attenuated in the drug treated group. Enhancement of survival was observed in drug treated groups as compared to control. It was 10 per cent in control as against 60, 86, 71, 57 and 50 per cent in the groups which received the test drug 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. It is concluded that the beneficial effect of the drug in the revival of monkeys subjected to acute haemorrhagic shock may be due to better maintenance of tissue perfusion.