Epidural administration of anesthetics and corticosteroids in treatment of acute radicular pain syndrome of lumbar spine in neurosurgical department
DOI:
https://doi.org/10.25305/unj.42450Keywords:
lower back pain, epidural injection, corticosteroidsAbstract
The purpose. To estimate efficacy of epidural administration corticosteroids and local anesthetics at radicular pain syndromes associated with discoradicular conflict in lumbar spine.
Materials and methods. Epidural injection of corticosteroids and local anesthetics were used in 348 patients with radicular pain syndromes in lumbar spine in the Neurosurgical Department of Vinnytsa Regional Psychoneurological Hospital. Procedures were performed in the operating room under local anesthesia. We administrated betamethasone 2 ml and bupivacaine 0.5% 5 ml.
Results. Positive result was achieved in 86.8% cases. As a rule patients reported a reduction in pain intensity right after the procedure, the effect increased on the 2nd–3rd day. In 54 (15.5%) patients pain intensity reduced by 30–50% after the first injection, so we performed it again. In 46 (13.2%) patients there was no relief, they were operated for intensive pain.
Conclusions. Epidural administration of corticosteroids and local anesthetics is an effective method of neurosurgical treatment of pain syndromes in the lumbar spine and radicular pain caused by inflammation, this method is characterized by low risk level and is used as a criteria for determining whether to perform surgery.
References
Kondrashov AA, Polishchuk NE. Effektivnost' epidural'nogo vvedeniya steroidov u patsiyentov s foraminal'nymi gryzhami mezhpozvonkovykh diskov poyasnichnogo otdela pozvonochnika i koreshkovym sindromom [The effectiveness of epidural steroids in patients with foraminal hernias of intervertebral discs of the lumbar spine and radicular syndrome]. Odes Med Zhurn. 2010;3:50-55. Russian.
Suslov VV, Khizhnyak AA, Tarabrin OA, Fesenko UA, Fesenko BC. Epiduralnaya anesteziya i analgeziya [Epidural anesthesia and analgesia]. Kharkov: KHMAPO; 2011. Russian.
Staehler RA. Lumbar epidural steroid injections for low back pain and sciatica [Internet]. Deerfield, IL: Spine-health (US); 1999 Nov 1 [updated 2007 Jul 17; cited 2014 Aug 23]. Available from: http://www.spine-health.com/treatment/injections/lumbar-epidural-steroid-injections-low-back-pain-and-sciatica.
Lee H, Weinstein J, Meller S, Hayashi N, Spratt K, Gebhart G. The Role of Steroids and Their Effects on Phospholipase A2. Spine. 1998;23(11):1191-1196. CrossRef
Ahadian F, McGreevy K, Schulteis G. Lumbar Transforaminal Epidural Dexamethasone. Regional Anesthesia and Pain Medicine. 2011;36(6):572-578. CrossRef
Cluff R, Mehio A, Cohen S, Chang Y, Sang C, Stojanovic M. The Technical Aspects of Epidural Steroid Injections: A National Survey. Anesthesia & Analgesia. 2002;95(2):403-408. CrossRef
Vitenbek IA, Kovalenko GA, Isangulova ST, Kaganov NM. Pobochnyye reaktsii i oslozhneniya epidural'noy analgezii mestnymi anestetikami [Adverse reactions and complications of epidural local anesthetics]. Anesteziologiya i Reanimatologiya. 1987 ;5:62-66. Russian.
Manchikanti L, Cash KA, McManus CD, Pampati V, Fellows B. Results of 2-year follow-up of a randomized, double-blind, controlled trial of fluoroscopic caudal epidural injections in central spinal stenosis. Pain Physician. 2012 Sep-Oct;15(5):371-84.
Nelson D. Dangers From Methylprednisolone Acetate Therapy by Intraspinal Injection. Archives of Neurology. 1988;45(7):804-806. CrossRef
Kondrashov OA. Epidural'ne vvedennya steroyidiv v likuvanni dyskohennoho bol'ovoho syndromu poperekovoho viddilu khrebta [Epidural steroid injection for lumbar discogenic pain] [abstracts of dissertation]. Kiev: Romodanov Neurosurgery Institute; 2012. Ukrainian.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Valeriy Olkhov, O. Buyanov, Kostyantyn Horbatyuk, O. Kudina, Leonid Ventskivskiy, O. Borodenko, Volodymyr Kirichenko, Ivan Ventskivskiy, Iurii Chyrka, Ruslana Dolgopolova
This work is licensed under a Creative Commons Attribution 4.0 International License.
Ukrainian Neurosurgical Journal abides by the CREATIVE COMMONS copyright rights and permissions for open access journals.
Authors, who are published in this Journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the Journal under the terms of Creative Commons Attribution License, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this Journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form of which it has been published by the Journal (for example, to upload the work to the online storage of the Journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this Journal is included.