게시판
| 21KS-019 |
Effectiveness of epidural steroid injection with 10% hypertonic saline in patients with post-herpetic neuralgia
1Department of Anesthesiology and
Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, Republic of Korea
2Department of Dental
Anesthesiology, Seoul National University Dental Hospital, Seoul, Republic of
Korea
*Correspondence should be addressed to Seong-Soo Choi
Background
Epidural steroid injection in Post-herpetic neuralgia (PHN) provides pain relief for a short duration only. Hypertonic solutions are known to produce better outcomes when added to epidural steroid injections in patients with spinal stenosis. This study aimed to evaluate the effect of adding hypertonic saline to epidural steroid injections in patients with PHN.
Methods
This double-blind, randomized, prospective trial included 39 patients who suffered for more than 4 month with PHN. Patients were randomly assigned into two groups: HS group, epidural steroid injection with hypertonic saline; and NS group, epidural steroid injection with normal saline. Numerical rating scale (NRS), insomnia severity index (ISI), medication quantification scale (MQS), global perceived effect (GPE) were measured at baseline, 1, and 3 months after the procedures. A linear mixed model was used in the statistical analysis.
Results
The results of intent-to-treat analysis showed that the pain intensities (NRS) of both groups were decreased from baseline at 1 and 3 months following each intervention (p<0.01 and p<0.01 respectively) without group differences (p=0.380). Sleep quality (ISI) of both groups was improved from baseline at 3 months after each intervention (p<0.01 and p<0.01 respectively) without group differences (p=0.123). No significant interactions between group and time in NRS and ISI (p=0.942 and p=0.981, respectively). MQS was also decreased in both groups at 3 months following each intervention (p<0.01) without group differences (p=0.129). However, we observed a significant interaction between the group and time effects in MQS (p=0.001). GPE was not differ at 1 and 3 months after the interventions between groups.
Conclusion
Addition of hypertonic saline to epidural steroid injection did not show beneficial effects of epidural steroid injection except for medication in patients with PHN.
Background
Epidural steroid injection in Post-herpetic neuralgia (PHN) provides pain relief for a short duration only. Hypertonic solutions are known to produce better outcomes when added to epidural steroid injections in patients with spinal stenosis. This study aimed to evaluate the effect of adding hypertonic saline to epidural steroid injections in patients with PHN.
Methods
This double-blind, randomized, prospective trial included 39 patients who suffered for more than 4 month with PHN. Patients were randomly assigned into two groups: HS group, epidural steroid injection with hypertonic saline; and NS group, epidural steroid injection with normal saline. Numerical rating scale (NRS), insomnia severity index (ISI), medication quantification scale (MQS), global perceived effect (GPE) were measured at baseline, 1, and 3 months after the procedures. A linear mixed model was used in the statistical analysis.
Results
The results of intent-to-treat analysis showed that the pain intensities (NRS) of both groups were decreased from baseline at 1 and 3 months following each intervention (p<0.01 and p<0.01 respectively) without group differences (p=0.380). Sleep quality (ISI) of both groups was improved from baseline at 3 months after each intervention (p<0.01 and p<0.01 respectively) without group differences (p=0.123). No significant interactions between group and time in NRS and ISI (p=0.942 and p=0.981, respectively). MQS was also decreased in both groups at 3 months following each intervention (p<0.01) without group differences (p=0.129). However, we observed a significant interaction between the group and time effects in MQS (p=0.001). GPE was not differ at 1 and 3 months after the interventions between groups.
Conclusion
Addition of hypertonic saline to epidural steroid injection did not show beneficial effects of epidural steroid injection except for medication in patients with PHN.
