Department of Anesthesiology and Reanimation, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey.
J Clin Ultrasound. 2021 Jan;49(1):20-27. doi: 10.1002/jcu.22923. Epub 2020 Sep 19.
Current conventional therapeutic strategies for lumbosacral pain during pregnancy are usually inadequate and data regarding interventional analgesic procedures feasible in pregnant women is scarce. We decided to retrospectively review our experience of ultrasound-guided pain management procedures in pregnant women with lumbosacral pain unresponsive to conservative treatment.
Twenty women in the second trimester of pregnancy with lumbosacral pain developed during pregnancy unresponsive to conservative treatments who underwent the following ultrasound-guided pain interventions were included: sacroiliac joint, caudal epidural, interlaminar epidural, and trigger point injections. All patients were followed up until early postnatal period using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores.
All but one patient achieved satisfactory pain control throughout the pregnancy with a single injection. Significant declines in ODI and VAS scores was attained within the first 2 weeks and first week of intervention, respectively, which was maintained thereafter until early postnatal period.
Injections used for effective interventional pain management in nonpregnant populations seem to represent an effective and safe method also for pregnant women when performed under ultrasound guidance, with rapid onset and enduring duration of action until the time of delivery.
目前针对妊娠期间腰骶部疼痛的常规治疗策略通常效果不佳，且关于孕妇可行的介入性镇痛程序的数据也很少。我们决定回顾性分析我们在常规保守治疗无效的妊娠中晚期腰骶部疼痛患者中实施超声引导下疼痛管理程序的经验。
20 例妊娠中晚期腰骶部疼痛患者，对常规保守治疗无效，接受以下超声引导下疼痛干预：骶髂关节、尾侧硬膜外、椎间孔硬膜外和触发点注射。所有患者均采用视觉模拟评分（VAS）和 Oswestry 残疾指数（ODI）评分进行随访至产后早期。
除 1 例患者外，所有患者单次注射后均能获得满意的镇痛效果。干预后第 2 周和第 1 周 ODI 和 VAS 评分显著下降，此后一直维持至产后早期。
在非妊娠人群中用于有效介入性疼痛管理的注射似乎代表了一种有效且安全的方法，在超声引导下也可用于孕妇，起效迅速，作用持续至分娩时间。
