在脊椎手术期间使用外周皮质类固醇可以减少术后疼痛吗? : 作为多模式止痛药的辅助剂
Hyun Song1, Charles Edwards, Ryan Curto
1Maryland Spine Center, Mercy Medical Center, Baltimore, MD.
Clinical spine surgery
|March 6, 2024
概括
在手术中使用的Depo-Medrol在手术后一周显著降低了背部疼痛. 这种类固醇的应用可能会增强术后疼痛管理策略.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 手术后疼痛是脊髓融合后的一个重大问题,影响恢复和阿片类药物使用.
- 术内使用类固醇已经显示出减轻腰部减压后疼痛的承诺.
- 在TLIF患者中,没有先前的研究研究了外周注射类固醇用于背部和根部疼痛.
研究的目的:
- 评估术后外周内置的Depo-Medrol在缓解术后背痛和激素炎中的疗效.
- 为了评估经过跨腰椎间体融合 (TLIF) 的患者的疼痛和根茎病症症状.
主要方法:
- 一项前性,随机,双盲,安慰剂控制的研究,涉及116名接受TLIF的患者.
- 德波-梅德罗尔或盐水被外周涂抹在瘤切除部位.
- 在多个术后时间点使用视觉模拟量表 (VAS) 评估疼痛.
主要成果:
- 接受Depo-Medrol治疗的患者在术后1至7天报告明显减少背痛 (P <0.05).
- 在第一周后,背部疼痛没有显著差异.
- 激素病症症状,包括腿部疼痛和麻木,在类固醇组中显示出减少的趋势.
结论:
- 在外科手术中使用的Depo-Medrol提供了1级证据,用于减少TLIF后的急性术后背痛.
- 周围注射式Depo-Medrol可以作为一种有价值的补充物,用于多种模式的止痛疗法,以增强疼痛缓解.
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