Clinical Efficacy of Epidural Injections of Local Anesthetic Alone or Combined with Steroid for Neck Pain: A Systematic Review and Meta-Analysis.


Journal

BioMed research international
ISSN: 2314-6141
Titre abrégé: Biomed Res Int
Pays: United States
ID NLM: 101600173

Informations de publication

Date de publication:
2022
Historique:
received: 02 03 2022
accepted: 09 05 2022
entrez: 6 6 2022
pubmed: 7 6 2022
medline: 9 6 2022
Statut: epublish

Résumé

To compare the effectiveness of cervical epidural injections of local anesthetic with vs. without a steroid. Three databases (PubMed, Embase, and Cochrane library) were used to search and assess all clinical randomized controlled trials regarding the clinical efficacy of epidural injections from January 01, 2009, to October 31, 2020. Cochrane review criteria and the Interventional Pain Management Techniques-Quality Appraisal of Reliability and Risk of Bias Assessment instrument were used to evaluate the methodologic quality of the included studies. Qualitative and quantitative analyses were performed according to best evidence synthesis principles and by single-arm meta-analysis, respectively. Based on the search criteria, 4 RCTs were qualitatively and quantitatively analyzed in the single-arm meta-analysis. Treatment with lidocaine alone or with the steroid resulted in decreases of 4.46 and 4.29 points, respectively, in pain scores and of 15.8 and 14.46 points, respectively, in functional scores at 6 months. Similar trends were observed at the 1-year follow-up: pain scores decreased by 4.27 and 4.14 points, while functional scores decreased by 15.94 and 14.44 points in patients with neck pain who received lidocaine without or with the steroid, respectively. In the 3 studies that reported 2-year follow-up data, patients with neck pain treated with lidocaine or lidocaine + steroid showed 4.2- and 4.14-point decreases, in pain score and 15.92- and 14.89-point decreases, respectively, in functional scores. The studies showed level I (strong) evidence for short- and long-term improvements in pain relief and functionality with cervical epidural injections of local anesthetic alone or with a steroid in the management of neck pain.

Identifiants

pubmed: 35663039
doi: 10.1155/2022/8952220
pmc: PMC9162875
doi:

Substances chimiques

Anesthetics, Local 0
Steroids 0
Lidocaine 98PI200987

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

8952220

Informations de copyright

Copyright © 2022 Bang-zhi Li et al.

Déclaration de conflit d'intérêts

The authors declare that they have no conflicts of interest.

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Auteurs

Bang-Zhi Li (BZ)

College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan 430061, China.
The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan 430070, China.

Wen-Hai Tang (WH)

Department of Spine Surgery, Second Affiliated Hospital of Hainan Medical College, Haikou 570100, China.

Yang Li (Y)

College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan 430061, China.
The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan 430070, China.

Lei Zhou (L)

College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan 430061, China.
The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan 430070, China.

Ming-Guo Liu (MG)

The Affiliated Hospital of Hubei University of Traditional Chinese Medicine, Wuhan 430070, China.
Department of Anesthesiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430061, China.
Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan 430070, China.

Sheng-Xue Bao (SX)

Department of Anesthesiology, Hubei Provincial Armed Police Corps Hospital, Wuhan 430060, China.

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