A meta-analysis on the efficacy of epidural corticosteroids in the treatment of sciatica
| Autor: | Watts Rw, Silagy Ca |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Injections
Epidural Critical Care and Intensive Care Medicine Placebo law.invention 03 medical and health sciences Sciatica 0302 clinical medicine Lumbar Randomized controlled trial law Adrenal Cortex Hormones Odds Ratio Medicine Humans 030212 general & internal medicine Epidural administration Adverse effect Randomized Controlled Trials as Topic business.industry 030208 emergency & critical care medicine Odds ratio medicine.disease Anesthesiology and Pain Medicine Radicular pain Anesthesia medicine.symptom business |
| Zdroj: | Anaesthesia and intensive care. 23(5) |
| ISSN: | 0310-057X |
| Popis: | The efficacy of epidural corticosteroids in the treatment of sciatica was investigated by meta-analysis of all randomized controlled trials. Eleven suitable trials of good quality were identified involving a total of 907 patients. The use of epidural (caudal or lumbar) steroid in the short-term (up to 60 days) increased the odds ratio (OR) of pain relief (>75% improvement) to 2.61 (95% CI 1.90–3.77) when compared with placebo. Despite some variations in trial characteristics there was little evidence of significant heterogeneity (P=0.07). When the trials were analysed for near or total relief of pain in the short-term the OR is 2.79 (95% CI 1.92–4.06), for heterogeneity (P=0.07). For longterm relief of pain (up to 12 months) the OR is 1.87 (95% CI 1.31–2.68). Efficacy is independent of the route of injection; for caudal epidural steroid the OR is 3.80 (95% CI 1.36–10.6) and for the lumbar epidural steroid 2.43 (95% CI 1.77–3.74). Adverse events included dural tap (2.5%), transient headache (2.3%) and a transient increase in pain (1.9%). There were no reported longterm adverse events. In conclusion we present quantitative evidence from meta-analysis of pooled data from randomized trials that epidural administration of corticosteroids is effective in the management of lumbosacral radicular pain. |
| Databáze: | OpenAIRE |
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