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Comparison of Trans-Foraminal Epidural Triamcinolone with or Without Local Anesthetic in Lumbar DISC Herniation for Pain Relief

Shruti H. Patel, Senior Resident, Department of Anaesthesiology, Government Medical College and Sir Takhtsinhji General Hospital, Bhavnagar, Gujarat 364001, India , Shruti H. Patel1 , Lopa H. Trivedi2 , Ravikumar M. Parmar3

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Indian Journal of Anesthesia and Analgesia 5(12):p 2067-2076, November 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51218.16

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Abstract

  Low back pain is a leading cause of disability and the commonest cause is intervertebral disc degeneration. We decide to compare the efficacy and safety of transforaminal epidural triamcinolone with or without local anaesthetic in the patients of Lumbar Disc Herniation for pain relief. Patients of low back pain with unilateral radiating pain not benefited by 6 weeks of conservative analgesia, having lumbar disc prolapse on X­ray and one­two level compression on MRI were included in the study. They divided into 2 groups; Group I receive fluoroscopic guided triamcinolone with bupivacaine, while Group II received Triamcinolone with normal saline. The patients were observed for improvement in VAS, ODI and at 3 weeks, 6 weeks and 9 weeks and analgesic intake after 9 weeks. The results showed improvement in VAS and ODI in both the groups but improvement was more in group I (p<0.05). Analgesic intake was also decrease in both the groups but more in Group I. We conclude fluoroscopic guided transforaminally injected triamcinolone is effective modality of treatment in lumbar disc degeneration patients. Its efficacy is improved by adding local anaesthetic with steroid. 


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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51218.16

Keywords

Transforaminal; Epidural Steroid; Visual Analogue Score; Oswestry Disability Index.

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