Affiliation:
1. Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
Abstract
Background: Previous meta-analyses examined only the short-term differences between
lidocaine and steroids vs lidocaine alone in treating lumbar degenerative diseases. Long-term
outcomes (1-2 years) in patients with lumbar disc herniation (LDH) and lumbar central spinal
stenosis (LCSS) have not yet been systematically evaluated.
Objective: The objective of our study was to assess quantitatively the difference in efficacy
at 1 to 2 years between lidocaine alone vs lidocaine and steroids for the management of LDH
or LCSS.
Study Design: We conducted a meta-analysis.
Methods: PubMed, EMBASE, and the Cochrane library were electronically searched up to July
22, 2016, for randomized controlled trials comparing lidocaine alone vs in combination with
steroids for the treatment of LDH and LCSS. Effective pain relief (EPR), Numeric Rating Scale
(NRS-11), Oswestry Disability Index (ODI), opioid intake (OI), and total employed increased
rate (TEIR) were the endpoints. Risk ratios (RRs) or weighted mean difference (WMD) with
95% confidence intervals (CIs) were calculated, and the pooled analysis was conducted using
RevMan 5.2.
Results: Seven trials were included. EPR was not significantly different at 1 and 2 years,
with RR = 1.08 (95% CI, 0.90-1.30; P = .39) and RR = 1.04 (95% CI, 0.92-1.18; P = .51),
respectively, in patients treated with lidocaine alone vs in combination with steroids. The NRS11 was also similar at 1 and 2 years. ODI and OI were not significantly different at 1 and 2
years. A similar TEIR effect was also observed for the 2 treatments.
Limitations: This meta-analysis relied on a small sample size of trials. Significant
heterogeneity among studies was observed. Several significant differences in terms of age of
the patients were reported in one included trial.
Conclusion: This meta-analysis confirmed the similar effects associated with lidocaine alone
vs in combination with steroids for the management of LDH and LCSS. Studies with longer
follow-up periods are still recommended.
Key words: Effective pain relief, lidocaine, long-term, lumbar central spinal stenosis, lumbar
disc herniation, Numeric Rating Scale, opioid intake, Oswestry Disability Index, steroids, total
employed increased rate
Publisher
American Society of Interventional Pain Physicians
Subject
Anesthesiology and Pain Medicine
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献