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Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain
BACKGROUND: Transforaminal epidural steroid injections are known to reduce inflammation by inhibiting synthesis of various proinflammatory mediators and have been used increasingly. The anti-inflammatory properties of opioids are not as fully understood but apparently involve antagonism sensory neur...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Pain Society
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710940/ https://www.ncbi.nlm.nih.gov/pubmed/23862000 http://dx.doi.org/10.3344/kjp.2013.26.3.265 |
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author | Park, Chan Hong |
author_facet | Park, Chan Hong |
author_sort | Park, Chan Hong |
collection | PubMed |
description | BACKGROUND: Transforaminal epidural steroid injections are known to reduce inflammation by inhibiting synthesis of various proinflammatory mediators and have been used increasingly. The anti-inflammatory properties of opioids are not as fully understood but apparently involve antagonism sensory neuron excitability and pro-inflammatory neuropeptide release. To date, no studies have addressed the efficacy of transforaminal epidural morphine in patients with radicular pain, and none have directly compared morphine with a tramadol for this indication. The aim of this study was to compare morphine and tramadol analgesia when administered via epidural injection to patients with lumbar radicular pain. METHODS: A total of 59 patients were randomly allocated to 1 of 2 treatment groups and followed for 3 months after procedure. Each patient was subjected to C-arm guided transforaminal epidural injection (TFEI) of an affected nerve root. As assigned, patients received either morphine sulfate (2.5 mg/2.5 ml) or tramadol (25 mg/0.5 ml) in combination with 0.2% ropivacaine (1 ml). Using numeric rating scale was subsequently rates at 2 weeks and 3 months following injection for comparison with baseline. RESULTS: Both groups had significantly lower mean pain scores at 2 weeks and at 3 months after treatment, but outcomes did not differ significantly between groups. CONCLUSIONS: TFEI of an opioid plus local anesthetic proved effective in treating radicular pain. Although morphine surpassed tramadol in pain relief scores, the difference was not statistically significant. |
format | Online Article Text |
id | pubmed-3710940 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | The Korean Pain Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-37109402013-07-16 Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain Park, Chan Hong Korean J Pain Original Article BACKGROUND: Transforaminal epidural steroid injections are known to reduce inflammation by inhibiting synthesis of various proinflammatory mediators and have been used increasingly. The anti-inflammatory properties of opioids are not as fully understood but apparently involve antagonism sensory neuron excitability and pro-inflammatory neuropeptide release. To date, no studies have addressed the efficacy of transforaminal epidural morphine in patients with radicular pain, and none have directly compared morphine with a tramadol for this indication. The aim of this study was to compare morphine and tramadol analgesia when administered via epidural injection to patients with lumbar radicular pain. METHODS: A total of 59 patients were randomly allocated to 1 of 2 treatment groups and followed for 3 months after procedure. Each patient was subjected to C-arm guided transforaminal epidural injection (TFEI) of an affected nerve root. As assigned, patients received either morphine sulfate (2.5 mg/2.5 ml) or tramadol (25 mg/0.5 ml) in combination with 0.2% ropivacaine (1 ml). Using numeric rating scale was subsequently rates at 2 weeks and 3 months following injection for comparison with baseline. RESULTS: Both groups had significantly lower mean pain scores at 2 weeks and at 3 months after treatment, but outcomes did not differ significantly between groups. CONCLUSIONS: TFEI of an opioid plus local anesthetic proved effective in treating radicular pain. Although morphine surpassed tramadol in pain relief scores, the difference was not statistically significant. The Korean Pain Society 2013-07 2013-07-01 /pmc/articles/PMC3710940/ /pubmed/23862000 http://dx.doi.org/10.3344/kjp.2013.26.3.265 Text en Copyright © The Korean Pain Society, 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Park, Chan Hong Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title | Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title_full | Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title_fullStr | Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title_full_unstemmed | Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title_short | Comparison of Morphine and Tramadol in Transforaminal Epidural Injections for Lumbar Radicular Pain |
title_sort | comparison of morphine and tramadol in transforaminal epidural injections for lumbar radicular pain |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710940/ https://www.ncbi.nlm.nih.gov/pubmed/23862000 http://dx.doi.org/10.3344/kjp.2013.26.3.265 |
work_keys_str_mv | AT parkchanhong comparisonofmorphineandtramadolintransforaminalepiduralinjectionsforlumbarradicularpain |