Department of Anesthesiology, Nara Prefectural Mimuro Hospital, Nara, Japan.
Department of Anesthesiology, Nara Prefectural Mimuro Hospital, Nara, Japan. ; Department of Anesthesiology, Heisei Memorial Hospital, Nara, Japan.
Korean J Pain. 2014 Apr;27(2):125-32. doi: 10.3344/kjp.2014.27.2.125. Epub 2014 Mar 28.
To improve residual pain management in acute cervical radiculopathy treated with NSAIDs, the feasibility of early and repeated low-dose interscalene brachial plexus block (IS-BPB) needs to be assessed.
This was a prospective study on patients receiving NSAIDs (loxoprofen) for cervical radiculopathy of ≤ 2-week onset. Pain was assessed using the visual analogue scale (VAS). A low-dose ultrasonography (USG)-guided IS-BPB (dexamethasone [1.65 mg; 0.5 ml] and mepivacaine [1%; 3.0 ml]) was performed at baseline and weekly thereafter for 4 weeks in an outpatient setting for the intervention group. All patients were evaluated using a visual satisfaction score (VSS) at week 4. Patients with baseline VAS scores < 70 (mild to moderate pain; MM group) and ≥ 70 (severe pain; SE group) were compared to the controls receiving NSAIDs.
A total of 316 IS-BPBs were performed in the intervention group. There was a significant difference in the decline in the VAS from week 0 to week 3 in the MM and SE groups (P < 0.05); however, from week 3 to week 4, the therapeutic effect exhibited no significant difference. Thirteen patients at week 2 (15.5%; MM: 27.7%; SE: 0%), 43 at week 3 (51.2%; MM: 83.0%; SE: 10.8%), and 47 at week 4 (56.0%; MM: 85.1%; SE: 18.9%) achieved a VAS score of ≤ 20. Patient satisfaction was high, and the decrease in VAS scores in both groups was significant (P < 0.05) compared to the controls.
Weekly, low-dose, USG-guided IS-BPB can be implemented for early pain relief in acute cervical radiculopathy, with high patient satisfaction.
为了改善接受 NSAIDs 治疗的急性颈神经根病的残留疼痛管理，需要评估早期和重复小剂量肩胛下臂丛神经阻滞（IS-BPB）的可行性。
这是一项针对发病时间不超过 2 周的颈神经根病患者使用 NSAIDs（洛索洛芬）的前瞻性研究。使用视觉模拟量表（VAS）评估疼痛。在基线和之后的每周在门诊进行一次小剂量超声（USG）引导的 IS-BPB（地塞米松[1.65 毫克；0.5 毫升]和甲哌卡因[1%；3.0 毫升]），持续 4 周。所有患者在第 4 周时使用视觉满意度评分（VSS）进行评估。将基线 VAS 评分<70（轻度至中度疼痛；MM 组）和≥70（重度疼痛；SE 组）的患者与接受 NSAIDs 的对照组进行比较。
干预组共进行了 316 次 IS-BPB。在 MM 和 SE 组中，从第 0 周到第 3 周 VAS 下降有显著差异（P<0.05）；然而，从第 3 周到第 4 周，治疗效果没有显著差异。第 2 周时有 13 名患者（15.5%；MM：27.7%；SE：0%），第 3 周时有 43 名患者（51.2%；MM：83.0%；SE：10.8%），第 4 周时有 47 名患者（56.0%；MM：85.1%；SE：18.9%）达到了 VAS 评分≤20。患者满意度较高，两组的 VAS 评分下降均有显著差异（P<0.05），与对照组相比。
每周、小剂量、USG 引导的 IS-BPB 可用于急性颈神经根病的早期止痛，且患者满意度高。
