PMID- 16510054
OWN - NLM
STAT- MEDLINE
DCOM- 20060407
LR  - 20181201
IS  - 0094-3509 (Print)
IS  - 0094-3509 (Linking)
VI  - 55
IP  - 3
DP  - 2006 Mar
TI  - Lidocaine patch 5 for carpal tunnel syndrome: how it compares with injections: a 
      pilot study.
PG  - 209-14
AB  - OBJECTIVES: A standard treatment option for mild-to-moderate carpal tunnel 
      syndrome (CTS) is a local injection of anesthetic-corticosteroid, but this can be 
      painful and may cause complications. This pilot clinical trial was designed to 
      compare the safety and efficacy of daily applications of the lidocaine patch 5% 
      to that of a single injection of 0.5 cc lidocaine 1% plus methylprednisolone 
      acetate (Depo-Medrol) 40 mg. METHODS: In this randomized, parallel-group, 
      open-label, single-center, active-controlled, prospective pilot study, 
      participants aged 18-75 years with clinical/electrodiagnostic evidence of CTS 
      were randomized to receive the lidocaine patch 5% or 1 injection of 0.5 cc 
      lidocaine 1% plus Depo-Medrol 40 mg. Outcome assessments included the Brief Pain 
      Inventory (measuring pain intensity, relief, and interference with quality of 
      life, Patient and Global Clinical Impression of Improvement, Global Assessment of 
      Treatment Satisfaction, and safety. RESULTS: Baseline characteristics of the 40 
      patients randomized to treatment with the lidocaine patch 5% (n=20) or injection 
      (n=20) were similar between groups. After 4 weeks of treatment, patients in both 
      groups reported significant changes (P<.05) in worst pain, average pain, and pain 
      "right now." Composite interference scores, which are measures of how much 
      patients' pain interfered with quality of life, also significantly improved in 
      both treatment groups (patch, -13.9; injection, -16.7; P<.001 vs baseline for 
      both groups). Eighty percent of patients in the lidocaine patch group and 59% of 
      patients who received the injection reported being "satisfied" or "very 
      satisfied," while investigators reported improvement in 88% of patients using the 
      lidocaine patch and in 74% of those who received the injection. Both treatments 
      were well tolerated, with treatment-related adverse events (AEs) reported in 3 
      patients in each group (15%). No systemic treatment-related AEs were observed 
      with the lidocaine patch 5%. CONCLUSIONS: This pilot trial demonstrated that the 
      lidocaine patch 5% was efficacious in reducing pain associated with CTS and was 
      well tolerated. The lidocaine patch 5% may offer patients with CTS effective, 
      noninvasive treatment for the management of their symptoms. Further controlled 
      trials are warranted.
FAU - Nalamachu, Srinivas
AU  - Nalamachu S
AD  - Mid-America Physiatrists, PA, Overland Park, KS 66211, USA. 
      nalamachu@sbcglobal.net
FAU - Crockett, R S
AU  - Crockett RS
FAU - Mathur, Deepan
AU  - Mathur D
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Fam Pract
JT  - The Journal of family practice
JID - 7502590
RN  - 0 (Anesthetics, Local)
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Drug Combinations)
RN  - 43502P7F0P (Methylprednisolone Acetate)
RN  - 98PI200987 (Lidocaine)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Administration, Cutaneous
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Analysis of Variance
MH  - Anesthetics, Local/*administration & dosage
MH  - Anti-Inflammatory Agents/administration & dosage
MH  - Carpal Tunnel Syndrome/*drug therapy
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Lidocaine/*administration & dosage
MH  - Male
MH  - Methylprednisolone/administration & dosage/analogs & derivatives
MH  - Methylprednisolone Acetate
MH  - Middle Aged
MH  - Patient Satisfaction
MH  - Pilot Projects
MH  - Statistics, Nonparametric
EDAT- 2006/03/03 09:00
MHDA- 2006/04/08 09:00
CRDT- 2006/03/03 09:00
PHST- 2006/03/03 09:00 [pubmed]
PHST- 2006/04/08 09:00 [medline]
PHST- 2006/03/03 09:00 [entrez]
AID - jfp_0306_5503c [pii]
PST - ppublish
SO  - J Fam Pract. 2006 Mar;55(3):209-14.