Assessing the impact of adding bupivacaine on immediate and delayed post-procedure pain scores in interlaminar epidural steroid injections.
Fluoroscopy
Local anesthetic
Lumbar epidural steroid injection
Spine percutaneous interventions
Journal
Skeletal radiology
ISSN: 1432-2161
Titre abrégé: Skeletal Radiol
Pays: Germany
ID NLM: 7701953
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
03
03
2021
accepted:
11
05
2021
revised:
11
05
2021
pubmed:
18
6
2021
medline:
1
12
2021
entrez:
17
6
2021
Statut:
ppublish
Résumé
A local anesthetic is frequently administered as part of a lumbar epidural steroid injection (LESI); however, there is a rare potential for this to result in transient paralysis if administered incorrectly. The purpose of this retrospective study is to determine if the addition of bupivacaine significantly improves patient-reported pain scores. This retrospective review includes patients undergoing LESI over an approximately 1 year time span. Pre-procedure, immediate post-procedure, and 1-week integer scaled pain scores were recorded. Ordinal regression was used to compare the distributions of the aggregated ordinal pain score categories between bupivacaine- and non-bupivacaine-injected patients. Two hundred fifty-eight patients met the inclusion criteria (126F:132 M, mean age 64.7 years) with 164 receiving bupivacaine and steroids and 94 receiving steroids alone. The relative frequency distributions for pre-injection pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.114). Similarly, the relative frequency distributions for immediate and 1-week post-procedure pain did not differ between the bupivacaine patients and the non-bupivacaine patients (p = 0.293 at immediate time point and p = 0.306 at 1-week time point). Odds ratios comparing pain severity change between the bupivacaine and non-bupivacaine patients also were not significantly different at either the immediate post-procedure (p = 0.769) or 1-week (p = 0.203) time points. The lack of a significant downward shift in the bupivacaine patients' post-procedure pain scores compared to the non-bupivacaine patients' post-procedure pain scores raises doubts about bupivacaine's utility as a standard component of a lumbar epidural injection.
Identifiants
pubmed: 34136939
doi: 10.1007/s00256-021-03817-5
pii: 10.1007/s00256-021-03817-5
doi:
Substances chimiques
Anesthetics, Local
0
Steroids
0
Bupivacaine
Y8335394RO
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
161-169Informations de copyright
© 2021. ISS.
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