Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey; Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey.
Am J Emerg Med. 2021 Apr;42:103-109. doi: 10.1016/j.ajem.2021.01.038. Epub 2021 Jan 20.
Low back pain (LBP) is a common musculoskeletal complaint among emergency department (ED) admissions. In this study, it was aimed to compare the effectiveness of systemic treatment with intradermal sterile water injection (ISWI) treatment protocol combined with systemic therapy in patients with LBP of unclear chronicity.
A prospective randomized, unblinded, controlled clinical study was conducted on patients admitted to the ED for LBP of unclear chronicity. One hundred twelve patients were randomly assigned to two groups; Group ISWI (n = 56) administered ISWI in the LBP region of patients along with systemic intravenous dexketoprofen therapy, while the other group (n = 56) received only systemic intravenous dexketoprofen therapy. The treatment methods' effectiveness was compared by measuring the pain intensity with the Visual Analog Scale (VAS) at admission, 10th minutes, 20th minutes, 30th minutes, and 24 h later. Also, opioid and analgesic consumptions in 24 h after treatment and patient satisfactions were compared.
In the treatment of LBP, ISWI treatment was found to be more effective in relieving pain than systemic therapy alone (p < 0.001). Also, it was observed that opioid consumption in the ED and analgesic consumption within 24 h after treatments were decreased in the ISWI group (p < 0.001). The patient satisfaction in the ED was statistically increased (p < 0.001).
In this unblinded study, ISWI with systemic therapy improved pain outcomes more than systemic therapy alone. Further research is needed to determine whether this was due entirely to placebo effect.
腰痛(LBP)是急诊科(ED)入院患者常见的肌肉骨骼投诉。在这项研究中,旨在比较系统性治疗与皮内无菌水注射(ISWI)治疗方案联合治疗不明原因慢性腰痛患者的疗效。
对因不明原因慢性腰痛而入住 ED 的患者进行前瞻性随机、非盲、对照临床研究。将 112 名患者随机分为两组;ISWI 组(n=56)在患者的腰痛区域给予 ISWI 联合全身静脉滴注右酮洛芬治疗,而另一组(n=56)仅接受全身静脉滴注右酮洛芬治疗。通过入院时、第 10 分钟、第 20 分钟、第 30 分钟和 24 小时后用视觉模拟评分(VAS)测量疼痛强度来比较治疗方法的疗效。还比较了治疗后 24 小时内阿片类药物和镇痛药的消耗以及患者满意度。
在治疗腰痛方面,与单独全身治疗相比,ISWI 治疗在缓解疼痛方面更有效(p<0.001)。此外,还观察到 ISWI 组在 ED 中阿片类药物消耗和治疗后 24 小时内镇痛药消耗减少(p<0.001)。ED 中的患者满意度统计上有所增加(p<0.001)。
在这项非盲研究中,与单独全身治疗相比,ISWI 联合全身治疗改善了疼痛结局。需要进一步的研究来确定这是否完全是由于安慰剂效应。