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KMID : 0948920170160020088
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Clinical Pain
2017 Volume.16 No. 2 p.88 ~ p.94
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Continuous Infusion of Saline with Dexamethasone by Indwelling Epidural Catheterin Patients with Spinal Stenosis
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Lee Han-Nah
Kim Eun-Sang
Do Jong-Geol
Kim Kyung-Ah
Moon Chang-Won
Kim Sang-Jun
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Abstract
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Objective: To find the therapeutic effect of continuous infusion of normal saline mixed with corticosteroid on spinal stenosis patients with poor outcome to conventional epidural steroid injection.
Method: Forty-two spinal stenosis patients who had failed to improve after epidural steroid injection were enrolled. A bolus of 10 mg of dexamethasone and 1,500 I.U hyaluronidase mixed with 1 ml of ropivacaine was injected and a total of 96 ml dexamethasone solution was infused over 48 hours at flow rate of 2 ml/hour by indwelling epidural catheter. The Oswestry Disability Index (ODI) was evaluated before and 1 month after procedure and the improvement of pain was evaluated 3 months after the procedure.
Results: Average ODI showed a significant change from 50.8 ± 18.2 to 45.7 ± 17.6 (p=0.025). Fourteen patients showed ‘much improvement’, 12 patients showed ‘slight improvement’ and 16 patients showed ‘no improvement’ at 3 months. There was no overlap in confidence intervals of change in ODI between responders and non-responders.
Conclusion: Continuous infusion of normal saline mixed with corticosteroid on spinal stenosis by indwelling epidural catheter was effective at 3 months for clinical improvement in about 61.9% of patients who had failed with conventional epidural steroid injection therapy.(
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KEYWORD
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Spinal stenosis, Indwelling catheter, Epidural, Pain
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