Eskandr Ashraf, Abdel Maseeh Sadik
Department of Anaesthesia, ICU and Pain Therapy, Faculty of Medicine, Menoufiya University, Shibin El-Koom 32518, Egypt.
Anesthesiol Res Pract. 2016;2016:7198048. doi: 10.1155/2016/7198048. Epub 2016 Aug 17.
Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0.5 mg, and dexmedetomidine (0.5 μg/kg) (group D) adjusted to the volume with normal saline. The effect was evaluated using visual analogue scale (VAS), analgesic requirement, and Oswestry disability index 2 weeks, 4 weeks, 8 weeks, and 12 weeks after injection. Results. VAS and ibuprofen consumption showed a significant reduction in group D. The Oswestry disability index was significantly improved in group D. There were no records of hypotension, bradycardia, sedation, or hypoxemia in both groups. Conclusion. The present study demonstrated potential safe and effective usage of adding dexmedetomidine to epidural steroid to control pain in patients with failed back surgery syndrome.
目的。腰椎手术失败综合征是一种需要快速、有效且高效管理的慢性疼痛病症。本研究评估在腰椎手术失败综合征患者的腰椎硬膜外类固醇注射中添加右美托咪定的效果。方法。50例腰椎手术失败综合征患者被随机分为两组，分别接受硬膜外注射20毫升由倍他米松（14毫克）和布比卡因0.5毫克组成的混合液（C组）或由倍他米松（14毫克）、布比卡因0.5毫克和右美托咪定（0.5微克/千克）组成的混合液（D组），并用生理盐水调整至相同体积。在注射后2周、4周、8周和12周，使用视觉模拟量表（VAS）、镇痛药物需求和Oswestry功能障碍指数评估效果。结果。D组的VAS和布洛芬消耗量显著降低。D组的Oswestry功能障碍指数显著改善。两组均无低血压、心动过缓、镇静或低氧血症的记录。结论。本研究证明在硬膜外类固醇中添加右美托咪定用于控制腰椎手术失败综合征患者的疼痛具有潜在的安全性和有效性。
