Treatment of sciatica at high altitude

ABSTRACT

Sciatic nerve block is one of the various diagnostic and therapeutic modalities for acute or chronic pain in the leg and foot. A randomized, retrospective, clinical study of 103 patients with symptoms of sciatic nerve root pain, was carried out at a remote place in the Northern areas at altitudes ranging from 9500-12000 feet. The inclusion criteria were; compromised morbidity, pain not responding to NSAIDs and a history of over one year. Age groups were 40-60 years and male to female ratio was 121. Ninety patients were given 0.125% bupivacain and 13 were given 0.5% lignocaine with 1800,000 adrenaline. Patients were put on aspirin 300 and ibuprofen 200 mg thrice a day for three days. A follow up of 4-6 months revealed a complete relief in 80% of the cases. Of the rest 20% most were those treated with lignocaine. An unexpected finding was that 80% of patients in bupivacain group had motor blockade and 20% had dense sensory block even at this lower concentration. In lignocaine group 100% of the patients had dense sensory blockade. We conclude that both lignocaine and bupivacain are effective in treating sciatica by sciatic nerve block at high altitude, bupivacain being a better choice; the population at this altitude is hyperreactive to both the drugs