Lumbar Epidural Anesthesia in the Treatment of Discal Lombosciatalgia: A Comparative Clinical Study between Methylprednisolone and Methylprednisolone with Levobupivacaine

Autor: Fátima Aparecida Emm Faleiros Sousa, Orlando Carlos Gomes Colhado
Rok vydání: 2011
Předmět:
Adult
Anesthesia
Epidural
Male
medicine.medical_specialty
Adolescent
medicine.drug_class
Visual analogue scale
Analgesic
Anti-Inflammatory Agents
TÉCNICAS DE ANALGESIA: Neuro eje
epidural
Methylprednisolone
Sciatica
Young Adult
Lumbar
ANESTÉSICO: Local
levobupivacaína
Double-Blind Method
medicine
ANESTÉSICOS: Local
levobupivacaína
Humans
Intervertebral Disk Displacement
Anesthetics
Local
Aged
Levobupivacaine
DOR: Neuropática
Local anesthetic
business.industry
Lumbosacral Region
TÉCNICAS DE ANALGESIA: Neuroeixo
peridural
DOLOR: Neuropática
ciática
Middle Aged
Bupivacaine
Epidural space
Surgery
Analgesia
Epidural
medicine.anatomical_structure
Anesthesiology and Pain Medicine
Anesthesia
Drug Therapy
Combination
Female
medicine.symptom
business
Intervertebral Disc Displacement
medicine.drug
Zdroj: Brazilian Journal of Anesthesiology. 61(5):544-555
ISSN: 0034-7094
DOI: 10.1016/s0034-7094(11)70065-4
Popis: Summary Background and objectives Lumbar epidural technique has been used in the treatment of lombosciatalgia since 1953. In most cases, methylprednisolone is used along with a local anesthetic, and it is not known whether the isolated use of methylprednisolone is equally effective in relieving symptoms. The objective of this study was to compare the efficacy of two different solutions – methylprednisolone with saline and methylprednisolone with levobupivacaine injected in the epidural space to heal lombosciatalgia secondary to lumbar herniated disk. Methods Sixty individuals ASA I and II, of both genders, ages 18 to 65 years participated in this randomized, double-blind study over a period of one year. They underwent interlaminar lumbar epidural analgesia without radioscopic control to heal a lombosciatalgia and they were divided into two groups: G-M (methylprednisolone + saline) and G-M + L (methylprednisolone + levobupivacaine + saline) both at a volume of 10 mL. Diagnosis was based on history, physical exam, and imaging exam (MRI). The Visual Analogue Scale (VAS) was applied in a total of two blockades, 15 days apart. Results A reduction in pain severity was observed in the methylprednisolone-levobupivacaine group, but without statistical significance. Conclusions The analgesic efficacy of the G-M + L solution was superior to that of the G-M solution in the treatment of discal lombosciatalgia regarding the shorter time to onset of analgesia, but this was not significant at the time of discharge, and both solutions were effective in the treatment of discal lombosciatalgia.
Databáze: OpenAIRE
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