Perineural Platelet-rich Plasma for Diabetic Neuropathy Pain
Condition: Diabetic Neuropathies; Chronic Pain
MeSH terms: Peripheral Nervous System Diseases; Diabetic Neuropathies; Chronic Pain
Study type: Interventional

Summary: 
      Peripheral neuropathy is very common in diabetes mellitus (DM). Till now there is no
      available effective therapy for this pathology. Objective: To evaluate the clinical effect of
      perineural platelet-rich plasma (PRP) injection as a treatment of diabetic peripheral
      neuropathy (DPN).
    

Detailed description: 
      Diabetic Peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM).
      Among several complications that contribute to reduce patient's quality of life and life
      expectancy diabetic neuropathy (DN) generalized or focal leads to an impaired life quality.

      The clinical symptoms of DPN range from pain and burning sensations, more at rest or at
      night; to hypoesthesia or paresthesia, and or numbness.

      Different types of peripheral neuropathy are observed in diabetes, axonal or demyelination or
      both can be present, involves myelinated and un-myelinated, large and small fibers. Nerve
      conduction studies can detect these changes. Till now, there is no effective therapy for the
      treatment of DPN.

      Since 1950 Platelet-rich plasma (PRP) has been used in dermatology and oral maxillofacial
      surgery, but its role as an effective alternative treatment in many other clinical
      applications has been increased over the last years.

      Platelets contain more than 1100 proteins, include enzymes, enzyme inhibitors, growth
      factors, immune messengers, and other bioactive compounds which play a role in tissue repair
      and wound healing.

      Autologous platelet-rich plasma found to promote axon regeneration in studies involving
      animal models. Platelet derived angiogenesis factors are capable of stimulating new capillary
      growth by inducing migration of endothelial cells. It was suggested that this was the
      mechanism by which platelet factors influence the process of angiogenesis and
      revascularization.
    

Intervention name(s): perineural injection of platelet-rich plasma; medical
Intervention type(s): Other; Drug
Intervention description(s): Sonographic guided injection was done under complete sterile conditions including skin sterilization, ultrasound probe covered with sterile pad, and a sterile gel. The needle was introduced from the lateral side toward midline using the in-plane approach to target the desired nerve, each nerve was injected by a single dose of 1.5 cc of PRP. Free hand one-man technique was used by the physician who simultaneously managed the ultrasound device by holding the syringe with one hand while scanning the nerve by moving the probe with the other hand. With continuous imaging of the tip of the needle, the syringe was put around the nerve and platelet-rich plasma was injected in the peri-neural tissue.; vitamin B complex, α lipoic acid, selective serotonin reuptake inhibitor (SSRI)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Diabetic Neuropathies; Chronic pain