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European Spine Journal

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01-02-2019 | Original Article

Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain

Authors: Akifumi Kanai, Takashi Okamoto, Norihito Hayashi, Junko Shimao, Yuki Nagahara, Kaoru Fujii

Published in: European Spine Journal | Issue 2/2019

Abstract

Purpose

To investigate the safety and efficacy of intrathecal injection as an alternative to epidural injection for analgesia.

Methods

Seventy consecutive outpatients with chronic low back and lower extremity pain received lumbar intrathecal injection of low-dose isobaric bupivacaine using a 25-gauge pencil-point needle. The patients received 0.5, 1.0, and 1.5 mg of bupivacaine at 1-week intervals to determine the optimal dose. Thereafter, they received two more weekly injections with the optimal dose. The safety and efficacy of the treatment were assessed over a 1-year period.

Results

No serious adverse events were encountered. The optimal dose of bupivacaine (1.0 mg in 60% of patients) alleviated pain and disability (both, p < 0.0001) and provided anesthesia below L1 (L5–T6). Motor block was negligible, and balance impairment improved relative to baseline (p < 0.0001).

Conclusion

Intrathecal injection of low-dose bupivacaine offers a safe and effective treatment for chronic low back and lower extremity pain.

Trial registration

The study was approved by the Kitasato University Hospital Ethics Committee, and written informed consent was obtained from all individual participants included in the study. This trial was registered with the University Hospital Medical Information Network (UMIN000008670).

Graphical abstract

These slides can be retrieved under electronic supplementary material.

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Title: Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain
Authors: Akifumi Kanai
Takashi Okamoto
Norihito Hayashi
Junko Shimao
Yuki Nagahara
Kaoru Fujii
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5801-z

At a glance: The STEP trials

Springer Medicine

Short-term results of intrathecal injection of low-dose bupivacaine in outpatients with chronic low back and lower extremity pain

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Graphical abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Graphical abstract

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