evaluation of genicular nerve blocks durations with and without corticosteroid: 一个单盲,随机对照试验:
Suzanna Shermon1, Terence Hillery2, Mi Mi Kim3
1Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH.
Pain physician
|April 1, 2025
概括
皮质类固醇添加到生殖神经阻塞 (GNBs) 中可能会在24小时内略微延长最初的疼痛缓解. 然而,带有或没有皮质类固醇的GNBs对膝关节骨关节炎的长期疼痛缓解没有显著的差异.
科学领域:
- 疼痛管理 疼痛管理
- 干预性疼痛医学 干预性疼痛医学
- 肌肉骨系统疾病 肌肉骨系统疾病
背景情况:
- 生殖神经阻塞 (GNBs) 经常用于预测膝关节骨关节炎的射频剥离 (RFA) 成功.
- 目前的GNB协议通常仅涉及局部麻醉,对其有效性持续时间的研究有限.
- 皮质类固醇在增强GNB结果中的作用仍未得到充分探索.
研究的目的:
- 在患有慢性膝关节关节炎的患者中,使用局部麻醉剂与皮质类固醇或不使用皮质类固醇的GNBs的疗效进行比较.
- 为了评估两种GNB技术之间的疼痛缓解百分比,持续时间和疼痛得分变化的差异.
- 评估将皮质类固醇添加到GNBs的潜在治疗益处.
主要方法:
- 一项随机前性试验与50名患有慢性膝关节关节炎的患者进行.
- 在光学指导下,患者被分配接受单独布皮瓦卡因 (对照剂) 或布皮瓦卡因与氨 (实验性) 组合.
- 疼痛评分,疼痛缓解百分比和缓解持续时间在基线,24小时,2周和6周后进行评估.
主要成果:
- 疼痛缓解的平均持续时间在治疗后24小时内,在皮质类固醇组 (0.87天) 与对照组 (0.64天) 相比,显着更长.
- 在任何随访时间点,在疼痛缓解百分比,整体疼痛缓解持续时间或数值评分表 (NRS-11) 得分方面没有观察到群体之间的显著差异.
- 疼痛缓解结果与患者人口统计学或骨关节炎严重程度之间没有发现显著的关联.
结论:
- 将皮质类固醇添加到GNB的局部麻醉剂中,可能会在前24小时内提供边际的,短期的疼痛缓解持续时间的增加.
- 在GNBs之后的几周内,两种技术之间没有发现止痛效果或止痛持续时间的显著差异.
- 这些发现表明,当添加到膝关节骨关节炎的GNB中时,皮质类固醇不会提供显著的治疗益处或长期缓解疼痛.
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