Published in:
01-04-2017 | Musculoskeletal
Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience
Published in: European Radiology | Issue 4/2017
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Objective
Evaluate patients’ intraoperative experience of percutaneous vertebroplasty (PV) performed without general anaesthesia in order to assess the feasibility of local anaesthesia and simple analgesic medication as pain control protocol.
Methods
Ninety-five patients who underwent single-site PV were consecutively included in the study between 2011 and 2013. Each procedure was achieved under local anaesthesia and perfusion of paracetamol, tramadol and dolasetron, with combined CT and fluoroscopy guidance. Numeric pain scale (NPS) was collected before, during and after intervention. After intervention, patients were asked to evaluate their experience as “very bad”, “bad”, “fair”, “good” or “very good”, independently of the pain.
Results
Indications for vertebroplasty were osteopenic fractures (78 %), aggressive angiomas (13 %) and somatic tumours (9 %). In 76 % of cases, patients’ experience was described as “very good” (44 %) or “good” (32 %), whereas 19 % described it as “fair” and 5 % as “very bad”. Mean operative NPS was 5.5. After intervention, NPS was significantly lower with a decrease of 4.5 points. No differences were found according to the localization, type of lesion, age or sex either in terms of experience or NPS.
Conclusion
Percutaneous vertebroplasty is feasible under local anaesthesia alone, with a very good or good experience in 76 % of the patients.
Key Points
• Vertebroplasty is a first-line therapy for consolidation and pain control of vertebral lesions.
• This procedure is commonly performed under general anaesthesia or conscious sedation.
• We perform vertebroplasty under local anaesthesia and simple analgesic protocol with acceptable experience.
• Percutaneous vertebroplasty can safely be proposed in a fragile population.