Effectiveness of ultrasound-guided perineural hydro-dissection with 5% dextrose for pronator teres syndrome: a case series

Abstract

Pronator teres syndrome (PTS) is s a proximal compressive neuropathy of the median nerve at the elbow level by the pronator teres muscle leading to pain and numbness in the area of the nerve distribution. Conservative treatment may be effective in 50-70% of cases with extremity rest and non-steroidal anti-inflammatory drugs, corticosteroids, and surgical decompression. Dextrose perineural hydro-dissection under ultrasound guidance is an interventional therapeutic option in cases of peripheral neuropathy due to nerve entrapment. This is a serial case study investigating the efficacy of dextrose perineural hydro-dissection for long-term pain relief in PTS. A numeric rating scale (NRS) and Quick-DASH (Quick-Disability of the Arm, Shoulder and Hand) were used to evaluate pre- and post-treatment states with ultrasound-guided 5% dextrose hydro-dissection therapy. All patients experienced satisfactory resolution on evaluation twelve months after treatment. In long-term evaluation, dextrose perineural hydro-dissection exhibits good clinical and functional outcomes for patients with PTS.
 Abbreviations: CTS - carpal tunnel syndrome; HD - hydro-dissection; NRS - numeric rating scale; PTS - Pronator teres syndrome; Quick-DASH - Quick-Disability of the Arm, Shoulder and Hand
 Key words: Pronator Syndrome; Pain; Perineural Hydro-Dissection; Median Neuropathy
 Citation: Tua Siahaan YM. Effectiveness of ultrasound-guided perineural hydro-dissection with 5% dextrose for pronator teres syndrome: a case series. Anaesth. pain intensive care 2023;27(5):607−613; DOI:
 10.35975/apic.v27i5.2318
 Received: July 11, 2023; Reviewed: August 27, 2023; Accepted: August 27, 2023