{"title":"膝神经阻滞治疗膝关节骨性关节炎患者的慢性疼痛。","authors":"Vlasta Orlić-Karbić, Alan Šustić","doi":"10.20471/acc.2023.62.s4.5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Therapeutic genicular nerve block (TGNB) is both an effective and safe treatment procedure for pain related to chronic osteoarthritis of the knee (OA). It is most common amongst the elderly. It is characterized by joint stiffness, pain and disability.</p><p><strong>Aim: </strong>The aim of this study was to examine the analgesic and functional impact of ultrasound-guided TGNB in patients with chronic knee OA and to evaluate the efficacy of local anesthetics and corticosteroids.</p><p><strong>Patients and methods: </strong>The study included 20 patients. Pain was assessed according to the numerical pain scale (NRS), and improvement of the functional capacity was assessed according to the WOMAC Index (Western Ontario and McMaster Universities Osteoarthritis Index). SLGN, SMGN and IMGN were identified, and 3 mL of a mixture of local anesthetic (ropivacaine 0.75%) and corticosteroid (triamcinolone 40 mg) were applied to each nerve.</p><p><strong>Results: </strong>The average NRS value before TGNB was 5.1, and the WOMAC score was 58.55. After the TGNB was performed, NRS was 2.4 (47% decrease in pain intensity) and WOMAC was 30.1 (51% decrease in the intensity of ailment).</p><p><strong>Conclusion: </strong>TGNB is effective and not harmful in treating pain and enhances the functional capacity in patients with knee OA. The clinical benefits of corticosteroid administration suggest that it may be an appropriate adjuvant in TGNB for knee OA.</p>","PeriodicalId":7072,"journal":{"name":"Acta clinica Croatica","volume":"62 Suppl4","pages":"34-39"},"PeriodicalIF":0.7000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128805/pdf/","citationCount":"0","resultStr":"{\"title\":\"THERAPEUTIC GENICULAR NERVE BLOCK FOR CHRONIC PAIN MANAGEMENT IN PATIENTS WITH KNEE OSTEOARTHRITIS.\",\"authors\":\"Vlasta Orlić-Karbić, Alan Šustić\",\"doi\":\"10.20471/acc.2023.62.s4.5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Therapeutic genicular nerve block (TGNB) is both an effective and safe treatment procedure for pain related to chronic osteoarthritis of the knee (OA). It is most common amongst the elderly. It is characterized by joint stiffness, pain and disability.</p><p><strong>Aim: </strong>The aim of this study was to examine the analgesic and functional impact of ultrasound-guided TGNB in patients with chronic knee OA and to evaluate the efficacy of local anesthetics and corticosteroids.</p><p><strong>Patients and methods: </strong>The study included 20 patients. Pain was assessed according to the numerical pain scale (NRS), and improvement of the functional capacity was assessed according to the WOMAC Index (Western Ontario and McMaster Universities Osteoarthritis Index). SLGN, SMGN and IMGN were identified, and 3 mL of a mixture of local anesthetic (ropivacaine 0.75%) and corticosteroid (triamcinolone 40 mg) were applied to each nerve.</p><p><strong>Results: </strong>The average NRS value before TGNB was 5.1, and the WOMAC score was 58.55. After the TGNB was performed, NRS was 2.4 (47% decrease in pain intensity) and WOMAC was 30.1 (51% decrease in the intensity of ailment).</p><p><strong>Conclusion: </strong>TGNB is effective and not harmful in treating pain and enhances the functional capacity in patients with knee OA. The clinical benefits of corticosteroid administration suggest that it may be an appropriate adjuvant in TGNB for knee OA.</p>\",\"PeriodicalId\":7072,\"journal\":{\"name\":\"Acta clinica Croatica\",\"volume\":\"62 Suppl4\",\"pages\":\"34-39\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128805/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta clinica Croatica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.20471/acc.2023.62.s4.5\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta clinica Croatica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.20471/acc.2023.62.s4.5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:治疗性膝神经阻滞(TGNB)是治疗慢性膝骨关节炎(OA)相关疼痛的有效且安全的治疗方法。这在老年人中最为常见。它的特点是关节僵硬,疼痛和残疾。目的:本研究的目的是研究超声引导下TGNB对慢性膝关节OA患者的镇痛和功能影响,并评估局麻药和皮质类固醇的疗效。患者和方法:本研究纳入20例患者。根据数值疼痛量表(NRS)评估疼痛,根据WOMAC指数(Western Ontario and McMaster university Osteoarthritis Index)评估功能能力的改善情况。鉴定SLGN、SMGN和IMGN,将局麻药(罗哌卡因0.75%)和皮质类固醇(曲安奈德酮40 mg)的混合物3 mL应用于每条神经。结果:TGNB术前平均NRS值为5.1,WOMAC评分为58.55。经TGNB治疗后,NRS为2.4(疼痛强度降低47%),WOMAC为30.1(疾病强度降低51%)。结论:TGNB对膝关节骨性关节炎患者的疼痛有有效、无害的治疗作用,并能提高患者的功能能力。皮质类固醇给药的临床益处表明,它可能是膝关节OA TGNB治疗的合适佐剂。
THERAPEUTIC GENICULAR NERVE BLOCK FOR CHRONIC PAIN MANAGEMENT IN PATIENTS WITH KNEE OSTEOARTHRITIS.
Background: Therapeutic genicular nerve block (TGNB) is both an effective and safe treatment procedure for pain related to chronic osteoarthritis of the knee (OA). It is most common amongst the elderly. It is characterized by joint stiffness, pain and disability.
Aim: The aim of this study was to examine the analgesic and functional impact of ultrasound-guided TGNB in patients with chronic knee OA and to evaluate the efficacy of local anesthetics and corticosteroids.
Patients and methods: The study included 20 patients. Pain was assessed according to the numerical pain scale (NRS), and improvement of the functional capacity was assessed according to the WOMAC Index (Western Ontario and McMaster Universities Osteoarthritis Index). SLGN, SMGN and IMGN were identified, and 3 mL of a mixture of local anesthetic (ropivacaine 0.75%) and corticosteroid (triamcinolone 40 mg) were applied to each nerve.
Results: The average NRS value before TGNB was 5.1, and the WOMAC score was 58.55. After the TGNB was performed, NRS was 2.4 (47% decrease in pain intensity) and WOMAC was 30.1 (51% decrease in the intensity of ailment).
Conclusion: TGNB is effective and not harmful in treating pain and enhances the functional capacity in patients with knee OA. The clinical benefits of corticosteroid administration suggest that it may be an appropriate adjuvant in TGNB for knee OA.
期刊介绍:
Acta Clinica Croatica is a peer reviewed general medical journal that publishes original articles that advance and improve medical science and practice and that serve the purpose of transfer of original and valuable information to journal readers. Acta Clinica Croatica is published in English four times a year.