Influence of prior opioid exposure on diagnostic facet joint nerve blocks
| Autor: | Bds Rajeev Manchukonda, Mark V. Boswell, James Giordano, Laxmaiah Manchikanti, RT Kimberly A. Cash |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Facet (geometry) Adolescent Lidocaine medicine.drug_class Medical Records Zygapophyseal Joint Facet joint Young Adult 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Humans Medicine False Positive Reactions Pharmacology (medical) In patient Anesthetics Local Aged Aged 80 and over Bupivacaine business.industry Local anesthetic Nerve Block General Medicine Middle Aged musculoskeletal system Arthralgia Surgery Analgesics Opioid Anesthesiology and Pain Medicine medicine.anatomical_structure Opioid Anesthesia Chronic Disease Facet joint pain Female business medicine.drug |
| Zdroj: | Journal of Opioid Management. 4:351-360 |
| ISSN: | 1551-7489 |
| DOI: | 10.5055/jom.2008.0039 |
| Popis: | Objective: To determine the influence of prior opioid use on the diagnostic validity of controlled comparative local anesthetic blocks in the diagnosis of facet joint involvement in chronic spinal pain.Methods: Data were evaluated from 438 patients with chronic spinal pain who underwent diagnostic facet joint nerve blocks. Patient data were divided into four groups based on the level of opioid use: group I (no opioid use), group II (low opioid use), group III (moderate opioid use), and group IV (high opioid use). Facet joint involvement was diagnosed utilizing controlled comparative local anesthetic blocks with 1 percent preservative- free lidocaine and 0.25 percent preservative-free bupivacaine.Results: Prior and current opioid use did not show relationship to the diagnostic validity of controlled comparative local anesthetic blocks. Among patients not using opioids (group I), the prevalence of facet joint pain was shown to be 33 percent in the cervical spine, 40 percent in the thoracic spine, and 18 percent in the lumbar spine, with false-positive results with a single lidocaine block of 53 percent, 33 percent, and 54 percent, respectively. Facet joint involvement in patients with opioid use ranged from 37 percent to 53 percent in the cervical spine, 13 percent to 67 percent in the thoracic spine, and 28 percent to 33 percent in the lumbar spine.Conclusions: Overall, this evaluation demonstrated that current or prior opioid use is not associated with interference of the validity of controlled comparative local anesthetic blocks in diagnosing spinal facet jointrelated pain. |
| Databáze: | OpenAIRE |
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