The Effectiveness of Different Corticosteroid Injections in Patients With Carpal Tunnel Syndrome: A Bayesian Network Meta-Analysis

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Corticosteroid injection is one of the interventions used to alleviate the symptoms of carpal tunnel syndrome. The consistency across domestic and overseas studies of the results of corticosteroid injections in terms of easing carpal tunnel syndrome has not previously been analyzed. This meta-analysis explored the symptom severity and functional status of different corticosteroid injection strategies in treating patients with carpal tunnel syndrome. A systematic review was performed, keywords including: carpal tunnel syndrome, corticosteroid [Title/Abstract], placebo, disability, and pain intensity were used to query electronic databases, including Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ProQuest, PubMed database. All of the articles that were indexed on these databases, met the inclusion criteria, and were published prior to June 2015 were extracted for analysis. A standardized critical appraisal tool from the "Cochrane Handbook Systematic Reviews of Intervention" to assess the risk of bias tool was used to assess methodological quality. WinBUGS software was used to conduct the meta-analysis. The 10 articles that were qualified and used in the present study contained a total of 633 participants. Median symptom severity was -1.16 (95%CrI [-1.95, .38]) on the symptom severity scale for ultrasound-guided in-plane injection among patients with carpal tunnel syndrome. The surface under the cumulative ranking curve (SUCRA) achieved 95%. The median MD was -.74 (95%CrI [-2.0, .52]) on the functional status scale for ultrasound-guided in-plane injection among patients with carpal tunnel syndrome. The (SUCRA) achieved 78%. The results indicate that the three injection methods reduced the severity and improved the functional status in comparison with the placebo, ultrasound-guided in-planecorticosteroid injection. Corticosteroid injections alleviate symptom severity and promote functional status in patients with carpal tunnel syndrome. Ultrasound-guided in-plane injections demonstrated greater effectiveness. The network meta-analysis provides a reference for rehabilitation nursing.