Intrasurgical use of steroids on carpal tunnel syndrome: a randomized, prospective, double-blind controlled study

We studied steroid irrigation of the median nerve during surgical decompression in carpal tunnel syndrome through a prospective randomized controlled study. After sample size calculation, 20 patients were randomized into two groups: one group had a release of the transverse carpal ligament alone, and the other one had a release associated with steroid irrigation of the median nerve. The patients were evaluated preoperatively and postoperatively at 15 days and 2 months through a widely used and validated patient-oriented measure (the Carpal tunnel questionnaire) and through neurophysiological evaluation. The follow-up assessment showed significant differences in the postoperative evolution between the two groups with regard to symptoms: symptoms were less in the steroid-treated group both at 15 days (p>0.035; z=−2.9) and at two months (p<0.005; z=−2.8). This suggests that steroid irrigation of the median nerve offers benefit compared with the transverse carpal ligament release alone. This study provides clear evidence of the use-fulness of the procedure in the post-operative evolution of symptoms.