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Comparison of Lidocaine and Bupivacaine in Lumbar Medial Branch Block

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2014, 21(1), pp.48-55
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

문상호 1 노장호 2 이송 1 Jeehyoung Kim 1 신원식 1

1서울성심병원정형외과학교실
2연세진통증의학과의

Accredited

ABSTRACT

Study Design: This is a retrospective clinical study. Objectives: To compare the efficacy of lidocaine and bupivacaine for the ultrasound-guided lumbar medial branch block in chronic lowback pain. Summary of Literature Review: There is no study for comparison of the efficacy between lidocaine and bupivacaine for the medialbranch block. Materials and Methods: From August 2011 to May 2013, 186 patients were assigned 0.5% lidocaine(n=136) or 0.25%bupivacaine(n=45) for the ultrasound-guided lumbar medial branch block. All procedures have been performed by the same operator, and23G, 10 cm needle was placed and drug was injected under ultrasound guide. To target medial branches from lumbar spinal nerve, thegroove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients wereevaluated by pre- and post-interventional(1 hour) Visual Analog Scale and analyzed statistically. Results: Reduction of VAS score in bupivacaine group is significantly greater than that in lidocaine group and post-interventional VASscore in bupivacaine group is significantly lower than that in lidocaine group through analysis of covariance test with adjusted preinterventionalVAS score. In multivariate analysis, while age, sex and treatment level were not significant factors, pre-interventionalVAS score and the kind of drug were significant factors. Severe pain before treatment and bupivacaine was indicator of better result. Bupivacaine group reduced pain score in the VAS 2.285 more than lidocaine group with adjustment with other factors. Conclusions: Bupivacaine is more effective than lidocaine in the reduction of pain after ultrasound-guided lumbar medial branch blocksin posterior facet joint syndrome.

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