Assessing the impact of adding bupivacaine on immediate and delayed post-procedure pain scores in interlaminar epidural steroid injections
| Autor: | Cody R. Quirk, Nicholas C. Nacey, James T. Patrie, Anthony Onofrio |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
030203 arthritis & rheumatology
Bupivacaine medicine.medical_specialty Epidural steroid Local anesthetic medicine.drug_class business.industry Post-Procedure Retrospective cohort study Odds ratio 030218 nuclear medicine & medical imaging 03 medical and health sciences Lumbar epidural steroid injection 0302 clinical medicine Anesthesia Orthopedic surgery medicine Radiology Nuclear Medicine and imaging business medicine.drug |
| Zdroj: | Skeletal Radiology. 51:161-169 |
| ISSN: | 1432-2161 0364-2348 |
| Popis: | A local anesthetic is frequently administered as part of a lumbar epidural steroid injection (LESI); however, there is a rare potential for this to result in transient paralysis if administered incorrectly. The purpose of this retrospective study is to determine if the addition of bupivacaine significantly improves patient-reported pain scores. This retrospective review includes patients undergoing LESI over an approximately 1 year time span. Pre-procedure, immediate post-procedure, and 1-week integer scaled pain scores were recorded. Ordinal regression was used to compare the distributions of the aggregated ordinal pain score categories between bupivacaine- and non-bupivacaine-injected patients. Two hundred fifty-eight patients met the inclusion criteria (126F:132 M, mean age 64.7 years) with 164 receiving bupivacaine and steroids and 94 receiving steroids alone. The relative frequency distributions for pre-injection pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.114). Similarly, the relative frequency distributions for immediate and 1-week post-procedure pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.293 at immediate time point and p = 0.306 at 1-week time point). Odds ratios comparing pain severity change between the bupivacaine and non-bupivacaine patients also were not significantly different at either the immediate post-procedure (p = 0.769) or 1-week (p = 0.203) time points. The lack of a significant downward shift in the bupivacaine patients’ post-procedure pain scores compared to the non-bupivacaine patients’ post-procedure pain scores raises doubts about bupivacaine’s utility as a standard component of a lumbar epidural injection. |
| Databáze: | OpenAIRE |
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