The Effect of Perineural Injection Treatment with 5% Dextrose on Clinical Improvement in Patients with Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Abstract

Introduction: Peripheral neuropathy is a global health problem with an increasing prevalence. Perineural Injection Therapy (PIT) is effective in the management of peripheral neuropathy through the mechanisms of inflammatory modulation and nerve function repair.
Objective: To evaluate the effectiveness of PIT in the management of peripheral neuropathy.
Methods: The databases used were ScienceDirect, PubMed, and Cochrane. Included articles were Randomized Controlled Trials (RCTs) with PIT 5% dextrose in sterile water (D5W) interventions in patients with peripheral neuropathy published within the last 10 years and assessing clinical improvement. Risk of bias was assessed based on the National Institutes of Health Assessment. Meta-analyses were conducted using Review Manager 5.4.1.
Results: PIT with D5W with a dose range of 1ml to 6ml provided significant improvements in SSS (MD = -4.58; 95% CI = -10.40 to -0.57, p=0.0004, I2=0%), FSS (MD = -2.82; 95% CI = -4.35 to -1.30, p=0.0003, I2=4.4%), VAS (MD = -1.29; 95% CI = -1.88 to -0.69, p<0.0001, I2=0%) up to more than 3 months after the intervention. However, it did not provide a significant effect on SNCV (MD = 0.46; 95% CI = -0.04 to 0.96, p=0.94, I2=0%), DML (MD = -0.20; 95% CI = -0.40 to 0.01, p=0.06, I2=0%), MNCV (MD = 0.77; 95% CI = -1.84 to 3.38, p=0.56, I2=0%), and quick-DASH (MD = -12.44; 95% CI = -37.19 to 12.30, p=0.32, I2=0%).
Conclusion: PIT with D5W has the potential to be an effective complementary intervention in the management of peripheral neuropathy.