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经椎间孔前硬膜外类固醇注射对神经性疼痛、睡眠质量和生活质量的影响。

Effect of transforaminal anterior epidural steroid injection on neuropathic pain, quality of sleep and life.

作者信息

Sarı Sinem, Aydın Osman Nuri, Güleser Gülsüm, Kurt İmran, Turan Alparslan

机构信息

Department of Anesthesiology and Reanimation, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.

Department of Algology, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.

出版信息

Agri. 2015;27(2):83-8. doi: 10.5505/agri.2015.91489.

Abstract

OBJECTIVES

Transforaminal anterior steroid injections are frequently used for low back pain. In the current study, It was aimed to investigate the effects of transforaminal anterior epidural steroid injection (TAESI) in patients with low back pain in regards to quality of life and sleep, and neuropathic pain.

METHODS

Ethics committee approval and patient consent were obtained. Patients with low back pain scheduled to receive transforaminal epidural steroid injections between October 2011 and October 2012 were included into the study. Pittsburgh Sleep Quality Index (PSQI), Short form 12 (SF 12), DN4 tests and Visual Analog Scale Score (VAS) were measured prior to procedure and three months later. All the tests were compared with baseline evaluations prior to injections.

RESULTS

One hundred and two (female/male: 52/50) patients with a mean age of 53.3 ± 1.4 were included. Primary diagnoses were lumbar disc herniation in eighty-seven patients, spinal stenosis in seven and failed back surgery syndrome in eight patients. Statistically significant improvement was seen in the total VAS, DN4 and PSQI scores (p=0.0001) of the patients at the third month follow-up. Sleep duration (p=0.0001), habitual sleep efficiency (p=0.0001), subjective sleep quality (p=0.003), sleep latency (p=0.014), sleep disturbances (p<0.001), sleep medication use (p=0.003), and day time dysfunction (p=0.015) showed a significant decrease in sub-components. There was no significant difference in SF 12 quality of life.

CONCLUSION

It was determined in the study that transforaminal epidural steroid injection provided a substantial improvement in patients' pain and neuropathic pain and quality of sleep, but had no effect on the quality of life.

摘要

目的

经椎间孔前路类固醇注射常用于治疗腰痛。在本研究中,旨在探讨经椎间孔前路硬膜外类固醇注射(TAESI)对腰痛患者生活质量、睡眠及神经性疼痛的影响。

方法

获得伦理委员会批准及患者同意。纳入2011年10月至2012年10月计划接受经椎间孔硬膜外类固醇注射的腰痛患者。在治疗前及三个月后测量匹兹堡睡眠质量指数(PSQI)、简明健康状况量表(SF-12)、DN4测试及视觉模拟评分(VAS)。所有测试结果均与注射前的基线评估进行比较。

结果

纳入102例患者(女性/男性:52/50),平均年龄53.3±1.4岁。主要诊断为腰椎间盘突出症87例,椎管狭窄7例,腰椎手术失败综合征8例。在第三个月随访时,患者的VAS总分、DN4及PSQI评分有统计学意义的改善(p=0.0001)。睡眠时长(p=0.0001)、习惯性睡眠效率(p=0.0001)、主观睡眠质量(p=0.003)、入睡潜伏期(p=0.014)、睡眠障碍(p<0.001)、助眠药物使用(p=0.003)及日间功能障碍(p=0.015)等子成分均有显著下降。SF-12生活质量方面无显著差异。

结论

本研究确定经椎间孔硬膜外类固醇注射可显著改善患者疼痛、神经性疼痛及睡眠质量,但对生活质量无影响。

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