Metin Ökmen Burcu, Ökmen Korgün, Altan Lale
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey.
Arch Rheumatol. 2018 Mar 23;33(4):464-472. doi: 10.5606/ArchRheumatol.2018.6754. eCollection 2018 Dec.
This study aims to investigate the effects of ultrasound-guided superficial branch of the radial nerve block on pain, function and quality of life in patients with hand osteoarthritis.
In this prospective, randomized and controlled single-blind study, 50 female patients (mean age 59.0±5.1 years; range, 46 to 64 years) diagnosed with hand osteoarthritis were randomized into two groups. Group 1 (n=25) was administered an ultrasound-guided superficial branch of the radial nerve injection (with a combination of 2 mL 0.25% bupivacaine and 1 mL methylprednisolone acetate) + exercise, while group 2 (n=25) only exercised. Patients were assessed with a visual analog scale for pain, hand grip strength, finger grip strength, Quick Disability of the Arm, Shoulder and Hand questionnaire, Duruöz Hand Index and Short-form 12. Data were obtained before treatment (W0), in the second week after treatment (W2) and in the fourth week after treatment (W4).
In group 1, a statistically significant improvement was obtained in all parameters at both W2 and W4 compared to the values recorded at W0 (p<0.05). In group 2, a statistically significant improvement was observed only in the parameters of hand grip strength and finger grip strength at W2 and W4 (p<0.05). A comparison of the scores of the two groups showed statistically significant superior improvement in group 1 in all parameters at both W2 and W4 (p<0.05).
The findings of our study showed that an ultrasound-guided superficial branch of the radial nerve block combined with exercise is a significantly superior treatment to exercise-only regarding the improvements in the parameters of pain, function and quality of life in hand osteoarthritis patients.
本研究旨在探讨超声引导下桡神经浅支阻滞对手部骨关节炎患者疼痛、功能及生活质量的影响。
在这项前瞻性、随机对照单盲研究中,50例诊断为手部骨关节炎的女性患者(平均年龄59.0±5.1岁;范围46至64岁)被随机分为两组。第1组(n = 25)接受超声引导下桡神经浅支注射(2 mL 0.25%布比卡因与1 mL醋酸甲基泼尼松龙混合液)+运动治疗,而第2组(n = 25)仅进行运动治疗。采用视觉模拟评分法评估患者疼痛程度、握力、手指握力,通过手臂、肩部和手部快速残疾问卷、杜罗兹手部指数及简明健康调查量表12项进行评估。在治疗前(W0)、治疗后第2周(W2)和治疗后第4周(W4)获取数据。
与W0记录值相比,第1组在W2和W4时所有参数均有统计学意义的显著改善(p<0.05)。第2组仅在W2和W4时握力和手指握力参数有统计学意义的显著改善(p<0.05)。两组评分比较显示,第1组在W2和W4时所有参数的改善均显著优于第2组(p<0.05)。
我们的研究结果表明,对于手部骨关节炎患者,在疼痛、功能及生活质量参数改善方面,超声引导下桡神经浅支阻滞联合运动治疗明显优于单纯运动治疗。