Add on effect of benfotiamine over pregabalin among patients with carpal tunnel syndrome in tertiary care specialty clinic – a randomized controlled trial

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Original Article

Author Details : S. Ramesh Kannan, Shanthi Kannan, Kalaiselvi Selvaraj, Manikandan

Volume : 4, Issue : 3, Year : 2017

Article Page : 116-121

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Abstract

Introduction: Carpal Tunnel syndrome is a common entrapment neuropathy involving the median nerve across the transverse carpal ligament. The diagnosis is clinical and confirmed by neurophysiological evaluation. Management varies from conservative as well as surgical. Since most of the patients prefer medical management we decided to compare the efficacy of benfotiamine, a neuro protective agent and pregabalin, a third generation anticonvulsant drug used for symptom relief.
Aim: The study was conducted to compare the efficacy of pregabalin in combination with benfotiamine, and pregabalin as monotherapy in the management of carpal tunnel syndrome (CTS).
Materials and Method: Fifty eight patients with CTS, who were diagnosed clinically and confirmed by nerve conduction study, were included through convenience sampling method. They were allocated to two groups: (i) treatment with pregabalin(n=30) and (ii) treatment with pregabalin in combination with benfotiamine (n=28) by simple randomization method. Symptom severity and functional status of these enrolled patients were compared before the intervention at recruitment and 12 weeks after the intervention using Boston Carpal Tunnel Syndrome Questionnaire (BCTQ).
Result: The mean difference in symptom severity scale (SSS) and functional status scale(FSS) scores between two treatment groups were analyzed by intention to treat method. Statistically significant differences were observed after 12 weeks of treatment in the FSS and SSS in both the groups, compared to the baseline.Patients who received combination treatment had higher scores after 12 weeks in the FSS as well as the SSS compared to pregabalin group [12 weeks score in SSS: pregabalin: 0.33±0.29, pregabalin+benfotiamine group: 2.16±0.58, p=0.0001, mean reduction in FSS: pregabalin: 0.14± 0.25, pregabalin+benfotiamine group:1.81±0.24, p=0.0001].
Conclusion: Combining benfotiamine with pregabalin is found to be effective in the conservative management of Carpal Tunnel Syndrome due to the different modalities of action. The long term efficacy of these drugs needs to be studied.

Keywords: Carpal Tunnel Syndrome, Pregabalin, Benfotiamine, Boston Carpal Tunnel Syndrome Questionnaire (BCTQ)

How to cite : Kannan S R, Kannan S, Selvaraj K, Manikandan, Add on effect of benfotiamine over pregabalin among patients with carpal tunnel syndrome in tertiary care specialty clinic – a randomized controlled trial. J Community Health Manag 2017;4(3):116-121

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