Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 26296
CLINICAL RESULTS OF CONTINUOUS EPIDURAL BUPIVACAIN INJECTION IN
THE TREATMENT OF LUMBOSCIATIC PAIN CAUSED BY LUMBAR SPINAL
STENOSIS AND DISC HERNIATION.
Taku NAKAKOHJI, Satoshi KAWASAKI, Gyo MURAKAMI
Department of Orthopaedic Surgery, Itabashi Chuo Medical Center, Tokyo (JAPAN)
Although epidural corticosteroid injection is commonly used for sciatica, the efficacy
of continuous epidural bupivacaine injection has not been established. METHODS: In
each of 24 patients with herniated nucleus pulposus (HNP) and 36 with lumbar
stenosis (LS), epidural catheter was inserted and 0.125% bupivacaine was injected 2
ml/H, 12 hours a day, for 7 days. Follow-up examination included pain evaluation
using VAS, and functional status using Japanese Orthopaedic Association score
(JOA score) at 2 weeks, 6 weeks, and 6 months. RESULTS: Seven patients of HNP
(30%) and 18 of LS (50%) showed significant improvement and returned to their work
or daily living without surgery. Their mean VAS decreased from 87 to 23. Seventeen
of HNP (70%) and 18 of LS (50%) did not showed improvement and 16 of HNP and
15 of LS received surgery. Their mean VAS decreased from 90 to 62, and their mean
JOA score of HNP group recovered from 8 points to 21 points 2 weeks later, and that
of LS group recovered from 9 to 23 points accordingly. There was no significant
difference concerning improvement between HNP and LS groups. There were four
minor complications. Superficial infections were detected in three patients and all of
them were recovered by removing catheters and taking oral antibiotics for a few
days. In one patient the catheter migrated into subdural space and caused transient
paralysis in both legs. CONCLUSION: Continuous epidural bupivacaine injection can
be recommended as an conservative therapy in acute phase of lumbosciatic pain.
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