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Medicinas Complementárias
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Pain Pract ; 20(2): 154-167, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31538405

RESUMEN

BACKGROUND: Lumbar radicular pain (LRP) results from inflammation and irritation of lumbar spinal nerves and the dorsal root ganglion (DRG). METHODS: Our study is a prospective, triple-blind, randomized, activecontrol trial (CTRI/2016/02/006666) comparing transforaminal epidural local anesthetic (LA) injection and pulsed radiofrequency treatment of DRG in patients with chronic LRP. Patients with LRP after failed conservative management for >3 months received selective diagnostic nerve root block with 1 mL 2% lidocaine. Fifty patients showing positive responses were divided into groups of 25 each. The LA group received transforaminal epidural injection of 1 mL 0.5% bupivacaine. The lumbar pulsed radiofrequency (LPRF) group received transforaminal epidural injection of 1 mL 0.5% bupivacaine with 3 cycles of pulsed radiofrequency of the DRG for 180 seconds RESULTS: Both groups were compared by observing pain intensity on a 0- to 100-point VAS and improvement in functional status by the Oswestry Disability Index (ODI version 2.0) at 2 weeks and 1, 2, 3, and 6 months. All baseline variables were comparable between the 2 groups. Statistically significant reduction in both outcomes was seen in the LPRF group compared to the LA group from 2 weeks to 6 months. One hundred percent of patients in the LPRF group had a ≥20- point decrease in VAS and significant percentage reduction in ODI at all time intervals up to 6 months, whereas it was seen in 80% and 28% of patients in the LA group at 3 and 6 months, respectively. No complications were seen in any patients CONCLUSION: Pulsed radiofrequency of the DRG applied for longer duration results in long-term pain relief and improvement in the functional quality of life in patients with chronic LRP.


Asunto(s)
Anestésicos Locales/administración & dosificación , Ganglios Espinales/efectos de los fármacos , Inyecciones Epidurales/métodos , Dolor de la Región Lumbar/terapia , Tratamiento de Radiofrecuencia Pulsada/métodos , Radiculopatía/terapia , Adulto , Anestesia Local/métodos , Método Doble Ciego , Femenino , Ganglios Espinales/diagnóstico por imagen , Humanos , Dolor de la Región Lumbar/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Bloqueo Nervioso/métodos , Manejo del Dolor/métodos , Dimensión del Dolor/métodos , Estudios Prospectivos , Calidad de Vida , Radiculopatía/diagnóstico por imagen
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