Dexmedetomidine versus hyaluronidase along with lumbar transforaminal epidural steroid injection in failed back surgery: a randomized double-blind clinical trial.

Background: Failed back surgery syndrome is a common problem faced by chronic pain management specialists. Steroid-only epidural injections have modest efficacy because of excessive scarring. Epidural hyaluronidase (HA), functions as a depolymerizing agent, successfully breaking down adhesions and collagen bundles, whereas dexmedetomidine (DEX) helps to reduce inflammation.

Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial.

Background: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections.

Methods: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups.

Efficacy of median nerve hydrodissection by hyalase versus midazolam in the treatment of carpal tunnel syndrome.

The objective was to determine which of midazolam or hyalase could improve the pain score and functional disability in median nerve hydrodissection. In a double-blind study with two groups, both received bupivacaine 15 mg with either 300 IU hyalase in 2 ml of saline (group HA) or 2 mg of midazolam in 2 ml of sterile saline (group MZ). Statistically significantly lower post-injection Visual Analog Scale scores in group MZ compared with group HA at all follow-ups.

Efficacy of transforaminal epidural magnesium administration when combined with a local anaesthetic and steroid in the management of lower limb radicular pain.

Background: Lower limb radicular pain resulting from a herniated intervertebral disc is a cause of functional disability and could lead to increased consumption of opioids. We evaluated the efficacy of epidural magnesium combined with a local anaesthetic and steroid in the management of this pain.

Methods: This was a prospective, case-control, randomized, double-blind study.