Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: A noncontrolled prospective study

Simone Vigneri, Valentina Paci, Gilberto Pari, Marco La Grua, Valentina Paci, Simone Vigneri, Gianfranco Sindaco, Laura Ravaioli, Matteo Zanella

Risultato della ricerca: Article

2 Citazioni (Scopus)

Abstract

Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment. Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural space, and each patient received an epidural injection of morphine chlorhydrate and bupivacaine up to three times a day. The medication was administered for 4 weeks. The pain intensity score on a 0-10 numeric rating scale (NRS), the total pain rating index rank (PRIr-T), and its coefficients were evaluated before treatment and 1 month after catheter removal. P-value <0.05 was considered statistically significant. Results: NRS and PRIr-T were significantly reduced at follow-up (P=0.001 and P=0.03, respectively), whereas the parallel evolution of the two scores (r=0.75 and P<0.001, respectively) confirmed significant pain relief lasting up to 1 month after treatment cessation. None of the four pain rating coefficients was significantly modified compared to the others in either responders or nonresponders. Successful clinical outcome (pain reduction >30% in NRS) was reached and maintained in half of the patients at follow-up. Conclusion: Combined epidural morphine and bupivacaine seems to be effective in the treatment of neuropathic pain.
Lingua originaleEnglish
pagine (da-a)1081-1087
Numero di pagine7
RivistaJournal of Pain Research
Volume9
Stato di pubblicazionePublished - 2016

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Bupivacaine
Neuralgia
Morphine
Prospective Studies
Pain
Withholding Treatment
Epidural Injections
Therapeutics
Epidural Space
Indwelling Catheters
Chronic Pain
Catheters

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cita questo

Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: A noncontrolled prospective study. / Vigneri, Simone; Paci, Valentina; Pari, Gilberto; La Grua, Marco; Paci, Valentina; Vigneri, Simone; Sindaco, Gianfranco; Ravaioli, Laura; Zanella, Matteo.

In: Journal of Pain Research, Vol. 9, 2016, pag. 1081-1087.

Risultato della ricerca: Article

Vigneri, Simone ; Paci, Valentina ; Pari, Gilberto ; La Grua, Marco ; Paci, Valentina ; Vigneri, Simone ; Sindaco, Gianfranco ; Ravaioli, Laura ; Zanella, Matteo. / Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: A noncontrolled prospective study. In: Journal of Pain Research. 2016 ; Vol. 9. pagg. 1081-1087.
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abstract = "Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment. Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural space, and each patient received an epidural injection of morphine chlorhydrate and bupivacaine up to three times a day. The medication was administered for 4 weeks. The pain intensity score on a 0-10 numeric rating scale (NRS), the total pain rating index rank (PRIr-T), and its coefficients were evaluated before treatment and 1 month after catheter removal. P-value <0.05 was considered statistically significant. Results: NRS and PRIr-T were significantly reduced at follow-up (P=0.001 and P=0.03, respectively), whereas the parallel evolution of the two scores (r=0.75 and P<0.001, respectively) confirmed significant pain relief lasting up to 1 month after treatment cessation. None of the four pain rating coefficients was significantly modified compared to the others in either responders or nonresponders. Successful clinical outcome (pain reduction >30{\%} in NRS) was reached and maintained in half of the patients at follow-up. Conclusion: Combined epidural morphine and bupivacaine seems to be effective in the treatment of neuropathic pain.",
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T1 - Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: A noncontrolled prospective study

AU - Vigneri, Simone

AU - Paci, Valentina

AU - Pari, Gilberto

AU - La Grua, Marco

AU - Paci, Valentina

AU - Vigneri, Simone

AU - Sindaco, Gianfranco

AU - Ravaioli, Laura

AU - Zanella, Matteo

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N2 - Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment. Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural space, and each patient received an epidural injection of morphine chlorhydrate and bupivacaine up to three times a day. The medication was administered for 4 weeks. The pain intensity score on a 0-10 numeric rating scale (NRS), the total pain rating index rank (PRIr-T), and its coefficients were evaluated before treatment and 1 month after catheter removal. P-value <0.05 was considered statistically significant. Results: NRS and PRIr-T were significantly reduced at follow-up (P=0.001 and P=0.03, respectively), whereas the parallel evolution of the two scores (r=0.75 and P<0.001, respectively) confirmed significant pain relief lasting up to 1 month after treatment cessation. None of the four pain rating coefficients was significantly modified compared to the others in either responders or nonresponders. Successful clinical outcome (pain reduction >30% in NRS) was reached and maintained in half of the patients at follow-up. Conclusion: Combined epidural morphine and bupivacaine seems to be effective in the treatment of neuropathic pain.

AB - Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment. Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural space, and each patient received an epidural injection of morphine chlorhydrate and bupivacaine up to three times a day. The medication was administered for 4 weeks. The pain intensity score on a 0-10 numeric rating scale (NRS), the total pain rating index rank (PRIr-T), and its coefficients were evaluated before treatment and 1 month after catheter removal. P-value <0.05 was considered statistically significant. Results: NRS and PRIr-T were significantly reduced at follow-up (P=0.001 and P=0.03, respectively), whereas the parallel evolution of the two scores (r=0.75 and P<0.001, respectively) confirmed significant pain relief lasting up to 1 month after treatment cessation. None of the four pain rating coefficients was significantly modified compared to the others in either responders or nonresponders. Successful clinical outcome (pain reduction >30% in NRS) was reached and maintained in half of the patients at follow-up. Conclusion: Combined epidural morphine and bupivacaine seems to be effective in the treatment of neuropathic pain.

KW - Bupivacaine; Chronic pain; Epidural; Neuropathic pain; Opioids; Anesthesiology and Pain Medicine

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