Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double-blind, controlled trial.
BJOG
; 124(2): 251-260, 2017 01.
Article
en En
| MEDLINE
| ID: mdl-27465823
ABSTRACT
OBJECTIVE:
To compare the effect of corticosteroids combined with local anaesthetic versus local anaesthetic alone during infiltrations of the pudendal nerve for pudendal nerve entrapment.DESIGN:
Randomised, double-blind, controlled trial.SETTING:
Multicentre study. POPULATION 201 patients were included in the study, with a subgroup of 122 women.METHODS:
CT-guided pudendal nerve infiltrations were performed in the sacrospinous ligament and Alcock's canal. There were three study arms patients in Arm A (n = 68) had local anaesthetic alone, those in Arm B (n = 66) had local anaesthetic plus corticosteroid and those in Arm C (n = 67) local anaesthetic plus corticosteroid with a large volume of normal saline. MAIN OUTCOMEMEASURES:
The primary end-point was the pain intensity score at 3 months. Patients were regarded as responders (at least a 30-point improvement on a 100-point visual analogue scale of mean maximum pain over a 2-week period) or nonresponders.RESULTS:
Three months' postinfiltration, 11.8% of patients in the local anaesthetic only arm (Arm A) were responders versus 14.3% in the local anaesthetic plus corticosteroid arms (Arms B and C). This difference was not statistically significant (P = 0.62). No statistically significant difference was observed in the female subgroup between Arm A and Arms B and C (P = 0.09). No significant difference was detected for the various pain assessment procedures, functional criteria or quality-of-life criteria.CONCLUSIONS:
Corticosteroids provide no additional therapeutic benefits compared with local anaesthetic and should therefore no longer be used. TWEETABLE ABSTRACT Steroid infiltrations do not improve the results of local anaesthetic infiltrations in pudendal neuralgia.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Corticoesteroides
/
Neuralgia del Pudendo
/
Anestésicos Locales
/
Lidocaína
/
Bloqueo Nervioso
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
BJOG
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Francia