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奇神经节阻滞改善尾骨痛的神经性疼痛:初步报告。

Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report.

作者信息

Sencan Savas, Kenis-Coskun Ozge, Demir Fatma Gul Ulku, Cuce Isa, Ercalık Tulay, Gunduz Osman Hakan

机构信息

Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.

Department of Physical Medicine and Rehabilitation, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.

出版信息

Neurol Neurochir Pol. 2018 Sep-Oct;52(5):612-617. doi: 10.1016/j.pjnns.2018.08.006. Epub 2018 Aug 28.

Abstract

AIM OF THE STUDY

To define the effectiveness of ganglion Impar block in improving neuropathic pain.

MATERIALS AND METHODS

Patients who had pain around the coccyx for more than three months and did not respond to conservative treatment were included in this study. All the patients underwent fluoroscopy guided transsacrococcygeal ganglion Impar block with injecting 3 mL of 0.5% bupivacaine, 2 mL saline, and 1 mL (40 mg) of methylprednisolone. Patients were evaluated with visual analog scale (VAS) for pain, Leeds assessment of neuropathic symptoms and signs scale (LANSS) for neuropathic pain, Beck depression Inventory (BDI) for mood and Short-form 12 (SF-12) for quality of life before, 1 month 3 months and 6 months after the injection. Patients' painless sitting duration was also recorded.

RESULTS

A total of 28 patients were included in the final analyses. VAS and LANSS scores improved significantly throughout the follow-up periods. BDI scores also improved while SF-12 scores did not show significant changes. Painless sitting period of the patients' improved significantly.

CONCLUSIONS

Ganglion Impar block is effective in decreasing the neuropathic component of chronic coccygodynia. This improves painless sitting in patients but its reflections on quality of life is not clear.

摘要

研究目的

确定奇神经节阻滞在改善神经性疼痛方面的有效性。

材料与方法

本研究纳入了尾骨周围疼痛超过三个月且对保守治疗无反应的患者。所有患者均在透视引导下接受经骶尾奇神经节阻滞,注射3毫升0.5%布比卡因、2毫升生理盐水和1毫升(40毫克)甲基泼尼松龙。在注射前、注射后1个月、3个月和6个月,使用视觉模拟评分法(VAS)评估疼痛程度,使用利兹神经病理性症状和体征评估量表(LANSS)评估神经性疼痛,使用贝克抑郁量表(BDI)评估情绪,使用简明健康调查量表(SF-12)评估生活质量。同时记录患者无痛坐姿持续时间。

结果

共有28例患者纳入最终分析。在整个随访期间,VAS和LANSS评分显著改善。BDI评分也有所改善,而SF-12评分未显示出显著变化。患者的无痛坐姿时间显著改善。

结论

奇神经节阻滞在减轻慢性尾骨痛的神经病理性成分方面有效。这改善了患者的无痛坐姿,但对生活质量的影响尚不清楚。

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