Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms

Nerve hydrodissection (HD), a technique used when treating nerve entrapments, involves the injection of an anesthetic, saline, or 5% dextrose in water to separate the nerve from the surrounding tissue, fascia, or adjacent structures. Animal models suggest the potential for minimal compression to ini...

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Bibliographic Details
Published in:Journal of pain research 2020-01, Vol.13, p.1957-1968
Main Authors: Lam, King Hei Stanley, Hung, Chen-Yu, Chiang, Yi-Pin, Onishi, Kentaro, Su, Daniel Chiung Jui, Clark, Thomas B, Reeves, K Dean
Format: Article
Language:English
Subjects:
Comparative analysis
Entrapment
Fractures
Methods
Monosaccharides
nerve hydrodissection
Nervous system
neuropathic pain
Pain
Pain management
Review
Sports injuries
Ultrasonic imaging
ultrasonography
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Summary:Nerve hydrodissection (HD), a technique used when treating nerve entrapments, involves the injection of an anesthetic, saline, or 5% dextrose in water to separate the nerve from the surrounding tissue, fascia, or adjacent structures. Animal models suggest the potential for minimal compression to initiate and perpetuate neuropathic pain. Mechanical benefits of HD may relate to release of nervi nervorum or vasa nervorum compression. Pathologic nerves can be identified by examination or ultrasound visualization. The in-plane technique is the predominant and safest method for nerve HD. Five percent dextrose may be favored as the preferred injectate based on preliminary comparative-injectate literature, but additional research is critical. Literature-based hypotheses for a direct ameliorative effect of dextrose HD on neuropathic pain are presented.
ISSN:1178-7090
1178-7090
DOI:10.2147/jpr.s247208