title: Alpha-lipoic Acid After Median Nerve Decompression at the Carpal Tunnel: A Randomized Controlled Trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Therapeutic I.
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. Electronic address: borianifilippo@gmail.com.
authors.forename: Filippo
authors.initials: F
authors.lastname: Boriani
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Granchi
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Roatti
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Luciano
authors.initials: L
authors.lastname: Merlini
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: Tania
authors.initials: T
authors.lastname: Sabattini
authors.affiliation: Rizzoli Orthopedic Institute, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Baldini
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009431:Neural Conduction; D018696:Neuroprotective Agents / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D008063:Thioctic Acid / Q000008:administration & dosage*; D014953:Wrist / Q000601:surgery
chemical_list: D018696:Neuroprotective Agents; D008063:Thioctic Acid
keywords: Carpal tunnel syndrome; alpha-lipoic acid; median nerve decompression; pillar pain