A comparative study of the efficacy of Neurobion and corticosteroid injections under ultrasound guidance in the treatment of carpal tunnel syndrome

comparative study of the efficacy of Neurobion and corticosteroid injections in patients with mild to moderate CTS

This study was a randomized, double-blind, parallel-group, controlled clinical trial conducted on 44 patients. Randomization was performed using the RAND function in Excel.

Samples will from Mahdieh Hospital, Modares Hospital, and Modaava Pain Clinic. The total sample size is 44 patients, who will be divided into two groups of 22. Group 1 will receive 1 ml of methylprednisolone and Group 2, Neurobion. Both injections will be administered under ultrasound guidance using in-plane technique with hydrodissection, delivered from the ulnar side.

Inclusion criteria: Individuals aged 20 to 65 years who meet the clinical criteria for carpal tunnel syndrome (CTS), including paresthesia, dysesthesia, pain, and hand weakness that are exacerbated by repetitive use or during sleep and relieved by shaking the hand, with positive Phalen’s and Tinel’s tests on physical examination, are eligible for inclusion. Diagnosis must be confirmed by electrodiagnostic testing. Exclusion criteria:Pregnancy; underlying metabolic disorders history of corticosteroid injection within the past three months; thenar muscle atrophy; prior CTS surgery; concomitant neuropathy or radiculopathy; and history of malignancy.

Patients were randomly allocated into two intervention groups: Group 1: Injection into the carpal tunnel using a local corticosteroid. Group 2: Injection into the carpal tunnel using Neurobion. Both injections were performed using the same technique, injection site, needle size, and injection volume to ensure procedural and visual uniformity between the two groups.

Age, Median Nerve Conduction Velocity, Nerve Response Latency, Pain Severity, Hand Symptoms and Function Severity

Patients will be allocated to the two treatment groups using simple randomization with a 1:1 allocation ratio. For this purpose, a numbered list will first be prepared for the 44 participants. Then, using the RAND function in Microsoft Excel, a random number will be generated for each participant. Based on the sorted random numbers, patients will be randomly assigned into two groups of 22 participants receiving either Neurobion or corticosteroid injection. The allocation sequence will be maintained by a person not involved in the outcome assessment process and will be placed in opaque, sequentially numbered sealed envelopes to ensure allocation concealment.

Patients were unaware of the type of medication administered, as the syringes were prepared by an independent individual and were identical in appearance and the injection volume was equal in both groups. The data analyst received the data set labeled only as Group A and Group B, and the allocation code was revealed only after completion of the statistical analysis and documentation of the results. Thus, neither the participants nor the data analyst were aware pf the type of intervention adminstered.