皮质类固醇剂量与神经关节注射后疼痛减轻之间的关联
William J Naber1, Darin Scribner, Claire Z Kalpakjian
1From the Department of Physical Medicine and Rehabilitation, University of Michigan Health, Ann Arbor, Michigan (WJN, DS, CZK, RB).
American journal of physical medicine & rehabilitation
|June 25, 2024
概括
较高的皮质类固醇剂量并没有改善神经关节注射的疼痛缓解. 这项研究表明,较低的剂量可能为背痛提供类似的益处,可能降低成本和副作用.
科学领域:
- 疼痛管理 疼痛管理
- 肌肉骨系统疾病 肌肉骨系统疾病
- 干预性疼痛程序 干预性疼痛程序
背景情况:
- 关节疼痛是背部疼痛的常见原因之一.
- 光学引导的皮质类固醇注射是一种公认的治疗方法.
- 对于神经关节注射的最佳皮质类固醇剂量尚未确立.
研究的目的:
- 为了研究皮质类固醇剂量与疼痛缓解之间的关系.
- 为了比较40毫克和80毫克甲基普雷迪尼索隆注射后的疼痛结果.
- 为了为未来的关节注射剂量指南提供信息.
主要方法:
- 对661名接受神经关节注射的患者的回顾性分析.
- 40毫克与80毫克甲基prednisolone剂量的比较.
- 疼痛评分变化的线性回归建模,控制共变量.
主要成果:
- 甲基普雷迪尼索隆剂量与缓解疼痛没有显著关联.
- 年龄和BMI也与疼痛减轻无显著关联.
- 女性性别接近统计学意义,表明潜在的疼痛分辨率较低.
结论:
- 皮质类固醇剂量可能不会显著影响神经关节注射的疼痛缓解.
- 较低剂量可以降低成本和潜在的副作用.
- 需要进一步的研究,以建立最佳的剂量准则.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
115
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
115
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
156
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
156
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
236
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
236
Local Anesthetics: Clinical Application as Spinal Anesthesia
614
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
614
Local Anesthetics: Clinical Application as Epidural Anesthesia
428
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
428


