Bloqueio esfenopalatino para analgesia na lombociatalgia: ensaio clínico randomizado duplo - cego placebo controlado.

Abstract

A usually unilateral lumbar pain that radiates to the posterior lateral aspect of the ipsilateral leg characterizes sciatica. It has a pattern of distribution following approximately the dermatome corresponding to the sciatic nerve, having a stitch or burning aspect and sometimes presenting loss of sensitivity of the affected region and loss of strength in plantar flexion and in the knee, especially when originated by disc herniation. A portion of the patients diagnosed with sciatica does not respond well to conservative treatment with analgesics and physiotherapy, requiring invasive surgical treatments that have limited duration of effectiveness. Thus, the objective of this study was to evaluate the effectiveness of the Sphenopalatine Ganglion Block, which is a safe and low complexity method, as an alternative in relieving painful symptoms in patients diagnosed clinically with Sciatica. Methods: A randomized, double-blind, placebo-controlled clinical trial was performed in a patients clinically diagnosed with Sciatica at the Neurology, Rheumatology and Orthopedics clinics of the Alcides Carneiro University Hospital in Campina Grande, Paraíba, using the Visual Analogue Scale as a measure for reduction of pain perception, being applied before, immediately after and after 7 days of the procedure. Results: There was a statistically significant difference between the three measures of the VAS (p <0.05), thus allowing us to assume that there was analgesia as a result of the procedure. We did not observe improvement in the betterment of sleep quality after the procedure, measured by the Pittsburgh’s scale. Patients’ demonstrated satisfaction as for the realization of the procedure and analgesia obtained, but were not satisfied with the results regarding daily activities, betterment of sleep quality and other symptoms. Conclusions: There was a statistically significant improvement in patients’ perception of pain, although further clarification is needed as to specify the origin of this analgesia. It seems that this reduction in pain was not followed by improvements in the capacity for daily activities, sleep quality and other symptoms, in accord to the patients’ perceptions.