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Hyaluronidase + bupivacaine is an investigational combination therapy being evaluated for the treatment of carpal tunnel syndrome (CTS) via ultrasound-guided median nerve hydrodissection. Hyaluronidase (brand name Hyalase) is an enzyme that facilitates tissue dissection and reduces nerve adhesions by temporarily breaking down hyaluronic acid in the interstitial barrier, acting as an adhesiolysis agent. Bupivacaine is a long-acting local anesthetic that provides pain relief during and after the procedure. This treatment modality aims to physically separate the median nerve from surrounding compressive tissues (hydrodissection) while chemically addressing adhesions and providing analgesia. It is currently being studied by researchers at Minia University and Assiut University.
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