Estudo Clínico Randomizado, Duplo Cego, em pacientes com Lombociatalgia submetidos ao uso da Metilprednisolona e Metilprednisolona associada à Clonidina no Bloqueio Lombar Via Hiato Sacral.

Abstract

this trial aims to compare the efficacy of two treatments for chronic low back pain. Lumbar pain is a common symptom and related to reduced quality of life and significant economic loss. Despite its high prevalence, pain control remains undefined. Methylprednisolone have been used, because it has great effectiveness, combined with faster action and fewer side effects when compared to long-term corticosteroids. Clonidine has been used as an effective analgesic when administered intrathecally and epidural way in patients with neuropathic pain, showing synergy with opioids. Porpuse: to evaluate the effects of methylprednisolone it self and methylprednisolone associated with clonidine way, injected into the epidural space through the sacral hiatus, in the treatment of patients with discogenic low back pain cause. Methods: study type randomized, controlled, double-blind, whose studied individuals have been allocated into two groups The trial has been performed at the Neurosurgical Clinic and Hemodynamics service of the University Hospital Alcides Carneiro (HUAC) at Campina Grande – PB, during the period between june 2012 and august 2014. Intervention: the selected individuals underwent an interview for evaluate aspects of pain and on its implications for quality of life, those question were conducted before the experiment, seven and twenty-eight days after. For patients belonging to group A, a solution was prepared with 80 mg methylprednisolone. And for patients in group B, a solution of 80 mg methylprednisolone associated with 150mcg clonidine. The experiment was made by the introduction of a spinal needle inside sacral hiatus, under radioscopic control. Results: Thirty minutes after the procedure, there was a significant improvement of pain in both groups. Seven days after the procedure the pain improvement has not been maintained, despite improvements remain at group A. Twenty-eight days after the procedure, it were observed a decline in pain relief and resumption of disability levels, there was no improvement of the signs of depression. Conclusion: for the population studied, injection of clonidine at a dose of 150mcg, via the sacral, is not better than use just methylprednisolone.