Pain, Acute
Conditions
Brief summary
Low back pain is one of the most common ailments that plagues patients, with nearly 80% of the population developing some form of back pain in their lifetime. Up regulated sodium channels in the nerve root or dorsal root ganglion are the basic cause for the mechano-sensitization and injecting the drug in the peripheral end of the nerve will block these sodium channels, since functionally both ends of the pseudo unipolar neuron are the same.
Detailed description
Low back pain is one of the most common ailments that plague patients, with nearly 80% of the population developing some form of back pain in their lifetime. Of all the causes of low back pain, the most common is lumbar radicular pain which may result from irritation of the nerve fibers or dorsal root ganglia due to intervertebral disc prolapse, degenerative spondylolisthesis or spinal canal stenosis. \[1\] Up regulated sodium channels in the nerve root or dorsal root ganglion are the basic cause for the mechano-sensitization and injecting the drug in the peripheral end of the nerve will block these sodium channels, since functionally both ends of the pseudo unipolar neuron are the same. \[2\]There have yet been no studies done to prove the efficacy of peripheral nerve block as an alternative to lumbar epidurals. We would like to share our experience of peripheral nerve blocks with low dose local Anaesthetics as the treatment of acute lumbosacral radiculopathy.
Interventions
PROCEDUREperipheral nerve block
peripheral nerve blocks with low dose lignocaine in acute radiculopathy
Sponsors
All India Institute of Medical Sciences, Rishikesh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 years to 60 years * Pain involving up to two segmental levels (L4, L5 and S1). * Average pain score of ≥5 on an 11-point NRS. * Tenderness over the concordant peripheral nerves (Gore sign +) * Computed tomography/Magnetic resonance imaging evidence of nerve root pain concordant with the side and level of clinical features.
Exclusion criteria
* Coagulopathy and/or patients on anticoagulants. * Infection at the site of injection. * Hypersensitivity to a local anaesthetic agent. * Evidence of significant sensory or progressive motor deficit. * Presence of cancer as a cause of back pain. * History of previous backs surgery/epidural steroid injection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ≥50% or ≥4 point reduction in an 10-point numeric scale (NRS) at, 1 month, 2 months and 3 months. | 3 months | change in pain intensity measured with numeric scale.Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an ten-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). |
Countries
India
Contacts
Primary ContactAJIT KUMAR, MD
Outcome results
None listed