Method for treating the cases of tunnel syndromes

FIELD: medicine.

SUBSTANCE: method involves applying infiltration anesthesia with Novocain or Lidocaine solution. The needle is introduced into compression zone above the tunnel. Actovegin is introduced into injured place at a dose of 80-200 mg after having preliminarily introduced the anesthetic. Actovegin is introduced into four biologically active points along the injured nerve path.

EFFECT: enhanced effectiveness of treatment; accelerated treatment course.

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The method is as follows. In treatment, foot reflexology, office clinic or hospital on the couch, the patient is reclined position in order to avoid an unconscious state and for complete relaxation. Insulin syringe prick biologically active points located along the affected nerve trunks with introducing 16-40 mg (0.2-0.5 ml) aktovegin. The number of points is not more than 6 in one session, a course of 6-8 sessions every day or two. Additionally, in the same session pharmacopuncture the influence of Actovegin method of infiltration anesthesia region of the tunnel of 0.5-2% solution of novocaine or lidocaine in the amount of 1.0-5.0 ml (the amount of solution will depend on the severity of pain and the size of the tunnel)through the needle into the compression zone, where, after the introduction of anesthetic solution to the location of the nerve is affected, without removing the needle from the tunnel, enter Actovegin dose of 80-200 mg (2-5,0 ml); in the course of 3-6 treatments daily or every other day.

The use of adequate doses of information pharmacogenet (aktovegin) 16-40 mg (0.2-0.5 ml) depending on the anatomical features of biologically active points located along the affected nerve proximally and distally to the tunnel. So in biologically active points of the shoulder and pelvic girdle, proximal the top and bottom is x extremities infiltered up to 40 mg (0.5 ml) aktovegin. In biologically active points of the distal upper and lower extremities enter up to 16 mg (0.2 ml) aktovegin.

The number of aktovegin entered the tunnel, must be optimal. It is determined by the diameter of infringements of neural patterns and the anticipated size of the tunnel. For example, the brachial plexus under the minor pectoral muscle radial nerve in placebotreated corner or spiral canal of the femoral nerve in the femoral triangle, the sciatic nerve in podkrashivanie space it is advisable to enter up to 200 mg (5.0 ml) aktovegin. A lower dose is sufficient to enter the syndrome of the front stair muscle, median, peroneal, and other neuropathies in the distal extremities.

Example 1. The reception was addressed by a man, 38 years old, locksmith, with complaints about a strong aching pain, numbness in right thigh, burning on the inner surface of the tibia, worse when walking at night. Disease associates with physical activity at work. Analgesics practically does not help the condition. In the objective status of the symptoms of loss from the femoral nerve, sharp pain in the exit point of the femoral nerve from under the inguinal ligament, expressed symptoms of tension of Waserman, Matskevich. Test the shortening of the iliopsoas muscle is negative. In the nerve conduction characteristics axonemal the Opatija femoral nerve on the right. Diagnosed tunnel femoral neuropathy in the groin area. Were treated by the modified method: in the exit area of the femoral nerve from under the inguinal ligament was administered 0.5% novocaine 5,0 ml and Actovegin in the amount of 200 mg (5.0 ml) daily for 1 week. At the same time carried pharmacopuncture, when introduced Actovegin dose 16-40 mg (0.2-0.5 ml) in point: VC-4, VC-5, RP-15 RP-11 RP-9 RP-8, RP-6, E-30, E-31, E-32 F-12, F-8, F-6, VB-31. The number of dots per session 4-6, 8 procedures performed in a day. Pain regressed after 4 injections. After 3 weeks appeared knee reflex, decreased hyperpathia. On the control ENMG positive dynamics. Ability to work recovered at 35 days of starting treatment. The patient was actively examined in six months. Bothered by recurrent pain in the right leg after heavy physical labor without disability. In the objective status of the slightly torpedo knee-jerk to the right, the symptoms of tension there.

Example 2. Turned a man 43 years old, Mason, with complaints of pain in right arm, numbness in the hands, weakness of the hand. Became ill after working in the cold. Objective: paresis of the extensor and instep brush to 1 point, sinergicheski paresis flexor up to 3 points, sensitive loss in the “anatomical snuffbox”, pain effleurage and pressure at 45 cm below the outer namesake shoulder. Positive supination test. When ENMG study rough myelinopathy radial nerve in the average Department. Diagnosed tunnel supinatory radial neuropathy. Treatment: was injected novocaine 0,5%-5,0 ml Actovegin 80 mg (2.0 ml) daily for 5 days and used a method of pharmacopuncture with the introduction of 16-40 mg aktovegin in biologically active points: GI-11, GI-10, GI-4, GI-5, GI-12, GI-13, GI-14, TR-5, TR-3, TR-6, TR-13, TR-12, TR-8, CV-8, CV-7, etc. through the day. The number of sessions 6. The pain disappeared after 2 injections, paresis almost regressed upon completion of the course of treatment. On the control ENMG light beam myelinopathy. After 2 months the patient is actively examined, revealed no pathology.

We treated 46 patients with tunnel neuropathies, including 32 women, 14 men from 26 to 52 years. Diagnosis tunnel nerve lesion was on the basis of the characteristic pain syndrome, sensitive stimulation (paresthesias), fallout (hypesthesia), musculoskeletal disorders (flaccid paresis, at least - paralysis) and trophic disorders in the Autonomous zone of the affected neural structures. Also used provocative manual tests and data stimulation and needle electroneuromyography. One group of patients and control of 23 people were assigned to conventional therapy: vitamins b, E, high energy phosphorus is s connection vasoactive tools, analgesics, massage, physiotherapy.

The other 23 patients, who represented the experimental group, in addition to vitamin and vascular funds were applied to the above modified method of treatment.

A comparative analysis of two groups was performed according to the following criteria: the timing of the regression of pain, paresthesia, muscle strength, trophic function, duration of disability, tolerance to treatment (see table 1).

Table 1
Criteria to compare 2 treatment technologiesThe control groupExperienced group
Regression paresthesia7-10 day2-4 day
Regression of pain10-21 day2-12 day
Recovery of muscle strength21-50 day7-30 day
Recovery of trophic functions20-50 day14-21 day
The period of temporary disabilityFrom 12 to 70 daysFrom 3 to 50 days

It turned out that the experimental group patients had stopped taking analgesics after 2-3 sessions, significantly reduced the period of temporary disability, were wrapping the awn treatment with pharmaco-economic advantage.

Thus, the proposed method can speed up the recovery of ischemic peripheral nervous tissue, elimination of pain syndrome, significantly reduce the period of temporary disability, to avoid drug polipragmazie, thus reducing the side effects of pharmaceuticals, non-steroidal analgesics in particular.

A method of treating tunnel syndromes, including the introduction of aktovegin 4-6 biologically active points located along the affected nerve, characterized in that the area of the tunnel by infiltration anesthesia solution of novocaine or lidocaine needle carried out in the compression zone, where, after the introduction of anesthetic solution, to the place where the nerve is affected, without removing the needle from the tunnel, enter Actovegin dose of 80-200 mg, on a course of 3-6 treatments daily or every other day, in biologically active points enter 16-40 mg aktovegin, on a course of 6-8 treatments daily or every other day.



 

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