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To examine the safety and efficacy of
intrathecal injection as a substitute to the epidural injection for analgesia.
As per CT evaluations, the presence of
common anatomical impediments to epidural injection, particularly at the L5–S1
level, may promote the failure of epidural injections in patients with low back
pain. These study results reveal that low-dose intrathecal injections of
isobaric bupivacaine are safe, tolerable, and effective in reducing pain and
disability in patients with low back and lower extremity pain.
To examine the safety and efficacy of
intrathecal injection as a substitute to the epidural injection for analgesia.
Total 70 consecutive outpatients with
chronic low back and lower extremity pain received a lumbar intrathecal
injection of low-dose isobaric bupivacaine via a 25-gauge pencil-point needle.
The patients received 0.5, 1.0, and 1.5 mg of bupivacaine at 1-week intervals
to determine the optimal dose. After that, they received two more weekly
injections with an optimal dose. The safety and efficacy of the treatment were
examined over 1 year.
There were no serious adverse
events. The optimal dose of bupivacaine (1.0 mg in 60% of patients) relieved
pain and disability (both, p<0.0001) and provided anaesthesia below L1
(L5–T6). Motor block was negligible, and balance impairment improved relative
to baseline (p<0.0001).
The intrathecal injection of
low-dose bupivacaine found to be safe and effective for the treatment of
chronic low back and lower extremity pain.
European Spine Journal
Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain
Akifumi Kanai et al.
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