GUEDES, A. T. L.; Thiago Alexandre Macedo de Azevedo.; http://lattes.cnpq.br/5439752194627541; http://lattes.cnpq.br/6463076029530696; GUEDES, Andiry Thamakave Leite.; AZEVEDO, Thiago Alexandre Macedo de.
Résumé:
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.