Alpha-lipoic Acid After Median Nerve Decompression at the Carpal Tunnel: A Randomized Controlled Trial

Filippo Boriani, Donatella Granchi, Giulia Roatti, Luciano Merlini, Tania Sabattini, Nicola Baldini

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose The postoperative course of median nerve decompression in carpal tunnel syndrome may be associated with complications. The aim of this study was to explore the possible effects of alpha-lipoic acid (ALA) in the postoperative period after surgical decompression of the median nerve at the wrist. Methods We conducted a double-blind prospective, randomized, controlled trial. A total of 64 patients with proven carpal tunnel syndrome were enrolled and randomly assigned into 1 of 2 groups: group A (n = 32) patients had surgical decompression of the median nerve followed by ALA for 40 days, and group P (n = 32) patients had surgical decompression followed by placebo. The primary end point of the study was a comprehensive indicator of sensory and motor nerve conduction velocity (electrophysiology score) at 3 months after surgery, Other end points were static 2-point discrimination, Boston Carpal Tunnel score, presence or absence of pillar pain, and use of analgesics beyond the second postoperative day. Results Alpha-lipoic acid did not improve nerve conduction velocity or Boston Carpal Tunnel score significantly. However, a statistically significant reduction in the postoperative incidence of pillar pain was noted in the ALA group. In addition, static 2-point discrimination improved in both groups. Conclusions Postoperative administration of ALA for 40 days after median nerve decompression may result in a lower incidence of pillar pain. This treatment is relatively well tolerated, which may support its value as standard postoperative supplementation after carpal tunnel decompression if further studies on larger samples confirm these preliminary findings. Type of study/level of evidence Therapeutic I.

Original languageEnglish
Pages (from-to)236-242
Number of pages7
JournalJournal of Hand Surgery
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

Keywords

  • alpha-lipoic acid
  • Carpal tunnel syndrome
  • median nerve decompression
  • pillar pain

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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