Effectiveness of dextrose volume on outcome of ultrasound guided hydrodissection of median nerve in patient with carpal tunnel syndrome.

Background: Carpal Tunnel Syndrome (CTS) results from median nerve compression, causing pain and dysfunction. Dextrose hydrodissection shows non-surgical promise, but the optimal volume is still unclear. Aim: To evaluate the effectiveness of high-versus low-volume dextrose in ultrasound-guided hydrodissection for improving clinical outcomes in patients with mild to moderate CTS. Methods: Thirty participants with mild to moderate CTS were randomized into two groups: Group A (high-volume) received 22 mL of hydrodissection fluid (20 mL of 5% dextrose + 2 mL of 1% lidocaine), while Group B (low-volume) received 5 mL (4 mL of 5% dextrose + 1 mL of 1% lidocaine). Results: Thirty CTS participants (15 per group) had similar baseline VAS pain scores (Group A: 7.8 ± 1.2; Group B: 7.6 ± 1.3). Group A showed significantly greater pain reduction at 1 week (3.2 ± 1.5 vs. 5.1 ± 1.4, p = 0.001), with continued improvement at 1 month (2.1 ± 1.0 vs. 4.3 ± 1.2, p < 0.001) and 3 months (1.5 ± 0.8 vs. 3.7 ± 1.0, p < 0.001). Functional outcomes and symptom severity scores also favored Group A at 3 months (1.0 ± 0.4 vs. 2.3 ± 0.5, p < 0.001). Sensory conduction velocity improved more in Group A (36.1 ± 4.0 m/s vs. 31.5 ± 3.8 m/s, p < 0.001), with both groups showing CMAP gains. Conclusion: High-volume ultrasound-guided dextrose hydrodissection proved more effective than low-volume in treating CTS, resulting in greater pain relief, improved function, and better nerve conduction outcomes.