Ação da pregabalina como adjuvante no pré operatório em pacientes com síndrome do túnel do carpo

OBJECTIVE: To evaluate the pregabalins adjuvant effect in patients with carpal tunnel syndrome (CTS) surgically treated, analyzing postoperative pain and the incidence of complex regional pain syndrome (CRPS). METHODS: Outpatient surgical candidates with CTS were selected and followed for 12 months, divided into three groups. The Control Group received a placebo, the Pregabalin 75mg Group received a daily dose, and the Pregabalin 150mg Group received a daily dose of the medication. Patient progress was evaluated using the visual analog scale (VAS) for pain and the DN4 neuropathic pain score before surgery, one month and three months after. RESULTS: The administration of pregabalin to surgical patients with CTS did not demonstrate significant differences in immediate postoperative pain relief. Additionally, there were no statistically significant variations in the incidence of complications, such as CRPS, among the groups. CONCLUSION: This study did not show a significant impact of pregabalin on postoperative pain relief or the reduction of CRPS incidence in patients undergoing surgery for CTS. These results suggest that pregabalin might not be an effective adjuvant in these surgical situations.OBJETIVO: Avaliar o efeito adjuvante da pregabalina em pacientes com síndrome do túnel do carpo (STC), tratados cirurgicamente, analisando a dor pós-operatória e a incidência da síndrome da dor complexa regional (SDCR). MÉTODOS: Foram selecionados pacientes com acompanhamento ambulatorial, com indicação de tratamento cirúrgico para STC, e acompanhados ao longo de 12 meses, divididos em três grupos. O Grupo Controle recebeu placebo, o Grupo Pregabalina 75mg tomou uma dose diária e o Grupo Pregabalina 150mg recebeu uma dose diária da medicação. A evolução dos pacientes foi avaliada mediante aplicação da escala visual analógica de dor (EVA) e o escore de dor neuropática DN4, antes da cirurgia, um mês e três meses após. RESULTADOS: A administração de pregabalina em pacientes cirúrgicos com STC não demonstrou diferenças significativas no alívio da dor pós-operatória imediata. Além disso, não houve variações estatisticamente significativas na incidência de complicações, como a SDCR, entre os grupos. CONCLUSÃO: Este estudo não evidenciou um impacto significativo da pregabalina no alívio da dor pós-operatória ou na redução da incidência da SDCR em pacientes submetidos a cirurgia para STC. Esses resultados sugerem que a pregabalina pode não ser um adjuvante eficaz nessas situações cirúrgicas

Acute Carpal Tunnel Syndrome due to Persistent Median Artery thrombosis: Case report

Abstract Carpal tunnel syndrome is the most common compressive neuropathy of the upper limb, affecting ~ 4% of the general population. The clinical picture is characterized by pain and, mainly, paresthesia in the median nerve territory, of insidious onset and, in the most severe cases, loss of strength and atrophy of the thenar musculature is observed. It is an extremely common pathology in the daily practice of hand surgery, and in most cases, it can be treated with conservative methods. We present here an atypical case of carpal tunnel syndrome, of acute onset, triggered by persistent median artery (PMA) thrombosis, condition associated with distal embolization and hypoper-fusion of the limb

Relationship of age and type of obstetric brachial plexus paralysis in forearm pronosupination

ABSTRACT Objective: To evaluate the arc of forearm pronosupination of patients with sequelae of birth paralysis and correlate with these variables. Methods: 32 children aged between 4 and 14 years with total or partial lesions of the , brachial plexus were evaluated; measurements of pronation and supination, active and passive, were made, both on the injured side and the unaffected side. Results: A statistically significant difference was observed between the injured side and the normal side, but there was no difference between the groups regarding age or type of injury. Conclusion: The age and type of injury did not impact on the limitation of the forearm pronosupination in children with sequelae of birth paralysis