Department of Anesthesia, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK.
Anaesthesia. 2011 Jul;66(7):595-603. doi: 10.1111/j.1365-2044.2011.06764.x. Epub 2011 May 13.
The question as to what constitutes the ideal epidural steroid injection remains unresolved. We performed a prospective, randomised, double-blind, AB/BA 2 × 2 crossover study of caudal 40 vs 80 mg methylprednisolone acetate (in 20 ml levobupivacaine 0.125%) in outpatients with chronic low back pain. Data from 33 participants were analysed. The Oswestry Disability Index improved in both dose groups over time following injection. However, a statistically significant improvement was only observed in the 40 mg methylprednisolone acetate group (40 mg: p < 0.001; 80 mg: p = 0.33). There was no statistically significant difference between the dose groups in change in the Oswestry Disability Index with respect to time. Methylprednisolone acetate 40 mg appears to be as effective as 80 mg in improving disability associated with chronic low back pain, and should be considered in preference to the 80 mg dose for outpatients with chronic low back pain attending for repeat caudal steroid injection.
硬膜外类固醇注射的理想药物构成仍未解决。我们对门诊慢性腰痛患者进行了一项前瞻性、随机、双盲、AB/BA2×2 交叉研究，比较了 40mg 和 80mg 甲泼尼龙醋酸酯（20ml 左旋布比卡因 0.125%）的疗效。分析了 33 名参与者的数据。注射后，两组患者的 Oswestry 残疾指数均随时间改善。然而，只有在 40mg 甲泼尼龙醋酸酯组观察到统计学显著改善（40mg：p<0.001；80mg：p=0.33）。两组间 Oswestry 残疾指数随时间的变化无统计学差异。40mg 甲泼尼龙醋酸酯在改善慢性腰痛相关残疾方面与 80mg 一样有效，对于接受重复硬膜外类固醇注射的慢性腰痛门诊患者，应优先考虑 40mg 剂量。
