Masoud Hashemi; Payman Dadkhah; Mehrdad Taheri; Mahshid Ghasemi
Volume 7, Issue 3 , July 2019, , Pages 245-250
Abstract
Objective: To evaluate the effects of dexmedetomidine in caudal epidural on controlling pain, erythrocyte sedimentation rate (ESR) and quality of life in patients with failed back surgery syndrome (FBSS).Methods: The study was a single-blind clinical trial. From the total of 70 patients suffering from ...
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Objective: To evaluate the effects of dexmedetomidine in caudal epidural on controlling pain, erythrocyte sedimentation rate (ESR) and quality of life in patients with failed back surgery syndrome (FBSS).Methods: The study was a single-blind clinical trial. From the total of 70 patients suffering from low back pain caused by a failed back surgery syndrome were referred to Akhtar and Imam Hossein Hospitals between the ages of 25 to 75 years with a history of back pain more than 12 weeks and a visual analogue scale (VAS) score of higher than 3, and 50 people were randomly selected and divided into two groups of dexmedetomidine and control. The control group received an epidural dose of 10 cc containing triamcinolone and bupivacaine, and the dexmedetomidine group received an epidural dose of 10 cc, containing dexmedetomidine, triamcinolones and bupivacaine with diluted normal saline. Epidural caudal injections were performed in the abdomen in a laid down position. Before starting the study and at the end of the fourth week, the two test groups were measured for visual analogue scale (VAS) and ESR and were asked to complete the quality of life questionnaire.Results: Overall, 50 patients with FBSS were enrolled. The mean age was 53.88 ± 8.9 years (range 25–75); 54% (27/50) were men. The results showed that the injection of dexmedetomidine in epidural caudal was associated with decreased pain (p=0.001) and improved quality of life (p=0.022), while showed no significant effect on ESR (p=0.110).Conclusion: Administration of dexmedetomidine in the epidural caudal is effective in controlling pain and quality of life in patients with failed back surgery syndrome.Clinical Trial Registry: IRCT20181012041316N1
Masoud Hashemi; Payman Dadkhah; Mehrdad Taheri; Mahshid Ghasemi; Ali Hosseinpour
Volume 7, Issue 2 , April 2019, , Pages 144-149
Abstract
Objective: To evaluate the effectiveness of transforaminal lumbar epidural steroid injections (TFESI) in patients with unilateral radiculopathy due to lumbar intervertebral disc protrusion regarding pain intensity, functional disability, current opioid intake and patients’ satisfaction.Methods: ...
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Objective: To evaluate the effectiveness of transforaminal lumbar epidural steroid injections (TFESI) in patients with unilateral radiculopathy due to lumbar intervertebral disc protrusion regarding pain intensity, functional disability, current opioid intake and patients’ satisfaction.Methods: The study is conducted in a pain management center (Tehran, Iran), during 2018. Inclusion criteria were age ≥18 years, radiculopathy for more than 6 months due to imagine-proved lumbar intervertebral disc protrusion and no response to conservative treatments. Exclusion criteria were spinal canal stenosis, lumbar surgery, and inability to communicate in Persian language. During a phone call interview, cases were instructed to rate their pain intensity according to the visual analogue scale (VAS), functional ability, satisfaction according to the patient satisfaction score (PSQ) and report current opioid use and additional injection and/or surgery.Results: Forty-three (89.5%) of the 48 subjects were reachable for study with mean age of 59.14 years and 16 subjects were men (37.2 %). Mean VAS after intervention was 4.67 and before the intervention was 6.91 (p=0.002). Mean functional disability before intervention was 47.23 and after intervention was 37 (p<0.001). Mean patient satisfaction score was 3.07 while 18 cases reported a PSQ level ≥4. 10 cases reported using opioid for analgesia, 23 cases reported receiving additional TFESIs and 11 reported having undergone lumbar surgery.Conclusion: Lumbar Epidural steroid injection is an effective non-surgical treatment option with regard to pain relief and improvement in functional ability with an average patients’ satisfaction during 2 years follow up although nearly 25% of patients may need additional injections and half of the patients may finally proceed to surgery.
