A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs
Background: Entrapment neuropathies, marked by nerve compression at various anatomical sites, can be effectively managed using conservative approaches like injections. Dextrose 5 % water injection has emerged as a potential therapy by reducing inflammation and promoting tissue regeneration. We aimed...
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Elsevier
2025-01-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844025000015 |
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| author | Fatemeh Azizi Faezeh Saber Gharesoo Fereshteh Eidy Sama Heidari Nastaran Maghbouli Shirin Djalalinia Amir Kasaeian |
| author_facet | Fatemeh Azizi Faezeh Saber Gharesoo Fereshteh Eidy Sama Heidari Nastaran Maghbouli Shirin Djalalinia Amir Kasaeian |
| author_sort | Fatemeh Azizi |
| collection | DOAJ |
| description | Background: Entrapment neuropathies, marked by nerve compression at various anatomical sites, can be effectively managed using conservative approaches like injections. Dextrose 5 % water injection has emerged as a potential therapy by reducing inflammation and promoting tissue regeneration. We aimed to evaluate dextrose injection's efficacy in treating entrapment neuropathies in upper extremities. Method: We systematically searched EMBASE, Scopus, Web of Science, and PubMed. Our eligibility criteria included participants aged 18 and older who had peripheral upper limb nerve entrapment from non-metabolic and non-traumatic sources. These participants were treated with dextrose injection compared to those receiving other injectables, such as corticosteroids and non-corticosteroid medications. The primary outcome was pain, with secondary outcomes including function, ultrasonographic, and electrodiagnostic findings. The quality of the clinical trials was assessed using Cochrane tools. Random-effect model was employed for meta-analysis. Results: Thirteen studies, involving 754 patients, were included, with only two showing serious bias risk. Initial findings indicate significant pain relief with dextrose injection within a short time (≤4 weeks) compared to normal saline (MD: −1.30, 95%CI: −2.12; −0.47). Dextrose also demonstrated a significant pain decrease compared to corticosteroids (MD: −0.81, 95 % CI: −1.40; −0.21) with low heterogeneity (I2 = 9 %, P = 0.36), and significantly improved function (MD = −0.46, 95 % CI: −0.76; −0.16) with low heterogeneity (I2 = 17 %, P = 0.31) in mid-term (one to six months). Conclusion: This meta-analysis suggests dextrose injection as an effective therapy for managing pain and restoring function in entrapment neuropathies. However, further high-quality studies are needed to confirm these findings and establish optimal dosing regimens and injection protocols. Healthcare providers should consider integrating dextrose injection into their treatment strategies for patients with entrapment neuropathies. |
| format | Article |
| id | doaj-art-ddcd4da3fc4548df9105f44f5381e0d7 |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-ddcd4da3fc4548df9105f44f5381e0d72025-01-17T04:51:46ZengElsevierHeliyon2405-84402025-01-01111e41622A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbsFatemeh Azizi0Faezeh Saber Gharesoo1Fereshteh Eidy2Sama Heidari3Nastaran Maghbouli4Shirin Djalalinia5Amir Kasaeian6Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, IranCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran; Student Research Committee, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, IranCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, IranCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, IranCenter for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran; Department of Physical Medicine and Rehabilitation, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Corresponding author. School of Medicine, Tehran University of Medical Sciences, Poorsina Ave, Tehran, Iran.Research and Technology, Ministry of Health and Medical Education, Tehran, Iran; Corresponding author. Ministry of Health, Treatment and Medical Education, Sima-Ye-Iran St., Shahrak Gharb, 1467664961, Tehran, Iran.Digestive Oncology Research Center, Digestive Diseases Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Chronic Inflammatory Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Clinical Research Development Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranBackground: Entrapment neuropathies, marked by nerve compression at various anatomical sites, can be effectively managed using conservative approaches like injections. Dextrose 5 % water injection has emerged as a potential therapy by reducing inflammation and promoting tissue regeneration. We aimed to evaluate dextrose injection's efficacy in treating entrapment neuropathies in upper extremities. Method: We systematically searched EMBASE, Scopus, Web of Science, and PubMed. Our eligibility criteria included participants aged 18 and older who had peripheral upper limb nerve entrapment from non-metabolic and non-traumatic sources. These participants were treated with dextrose injection compared to those receiving other injectables, such as corticosteroids and non-corticosteroid medications. The primary outcome was pain, with secondary outcomes including function, ultrasonographic, and electrodiagnostic findings. The quality of the clinical trials was assessed using Cochrane tools. Random-effect model was employed for meta-analysis. Results: Thirteen studies, involving 754 patients, were included, with only two showing serious bias risk. Initial findings indicate significant pain relief with dextrose injection within a short time (≤4 weeks) compared to normal saline (MD: −1.30, 95%CI: −2.12; −0.47). Dextrose also demonstrated a significant pain decrease compared to corticosteroids (MD: −0.81, 95 % CI: −1.40; −0.21) with low heterogeneity (I2 = 9 %, P = 0.36), and significantly improved function (MD = −0.46, 95 % CI: −0.76; −0.16) with low heterogeneity (I2 = 17 %, P = 0.31) in mid-term (one to six months). Conclusion: This meta-analysis suggests dextrose injection as an effective therapy for managing pain and restoring function in entrapment neuropathies. However, further high-quality studies are needed to confirm these findings and establish optimal dosing regimens and injection protocols. Healthcare providers should consider integrating dextrose injection into their treatment strategies for patients with entrapment neuropathies.http://www.sciencedirect.com/science/article/pii/S2405844025000015InjectionNerve compression syndromeGlucoseCarpal tunnel syndromeUlnar neuropathyDextrose |
| spellingShingle | Fatemeh Azizi Faezeh Saber Gharesoo Fereshteh Eidy Sama Heidari Nastaran Maghbouli Shirin Djalalinia Amir Kasaeian A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs Heliyon Injection Nerve compression syndrome Glucose Carpal tunnel syndrome Ulnar neuropathy Dextrose |
| title | A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| title_full | A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| title_fullStr | A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| title_full_unstemmed | A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| title_short | A systematic review and meta-analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| title_sort | systematic review and meta analysis of the effectiveness of perineural dextrose injection in peripheral compression neuropathies of the upper limbs |
| topic | Injection Nerve compression syndrome Glucose Carpal tunnel syndrome Ulnar neuropathy Dextrose |
| url | http://www.sciencedirect.com/science/article/pii/S2405844025000015 |
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