Ignite Creation Date:
2024-06-16 @ 11:49 AM
Last Modification Date:
2024-10-26 @ 3:31 PM
Study NCT ID:
NCT06438952
Status:
RECRUITING
Last Update Posted:
2024-06-03
First Post:
2024-05-20
Brief Title:
Efficacy and Duration of Pain Relief in Transforaminal and Lumbar Sympathetic Blocks
Sponsor:
Bezmialem Vakif University
Organization:
Bezmialem Vakif University
Study Overview
Official Title:
Efficacy and Duration of Pain Relief in Transforaminal and Lumbar Sympathetic Blocks
Status:
RECRUITING
Status Verified Date:
2024-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Low back pain is a symptom that is frequently seen in the general population and reduces the quality of life of patients Conventional medical treatment for patients with low back pain includes oral medication lifestyle modification education exercises lumbar traction and manual manipulation heat application and other interventional procedures Epidural injections one of the interventional procedures are one of the common treatment methods for low back pain especially caused by disc prolapse Steroids are commonly used to reduce inflammation in the epidural space Epidural steroid injection can be given to the lumbar epidural space via transforaminal interlaminar and caudal routes and the effectiveness rate of each is different These interventional methods used to treat low back pain can be applied in combination
The main purpose of this study is to observe how adding lumbar sympathetic blockade will affect the patients pain in the postoperative period in patients to whom we applied caudal epidural and transforaminal steroid injection
The main purpose of this study is to observe how adding lumbar sympathetic blockade will affect the patients pain in the postoperative period in patients to whom we applied caudal epidural and transforaminal steroid injection
Detailed Description:
Low back pain is a symptom that is frequently seen in the general population and reduces the quality of life of patients Conventional medical treatment for patients with low back pain includes oral medication lifestyle modification education exercises lumbar traction and manual manipulation heat application and other interventional procedures 1 2 Epidural injections one of the interventional procedures are one of the common treatment methods for low back pain especially caused by disc prolapse Steroids are widely used to reduce inflammation in the epidural space 3 4 Epidural steroid injection can be administered to the lumbar epidural space via transforaminal interlaminar and caudal routes and each has different efficacy rates 5-7
Sympathetically maintained pain including lumbar sympathetic ganglion block LSGB complex regional pain syndrome CRPS types I and II neuropathies such as postherpetic neuralgia stump or phantom limb pain diabetic polyneuropathy and ischemic pain from vascular insufficiency in the lower leg It is a widely applied procedure for diagnosing and managing diseases 8 The autonomic nervous system consists of sympathetic and parasympathetic departments As the name suggests blood supply to the lower extremity increases after lumbar sympathetic block This is useful in sympathetic system-mediated treatment of pain 9
The most important reason for adding fentanyl and magnesium as adjvams is to improve the quality of analgesia and provide analgesia for a longer period of time Both fentanyl and magnesium have the ability to modulate neurotransmitter release and affect neuronal excitability Fentanyl demonstrates the role of the sympathetic nervous system in modulating pain by increasing the effectiveness of endogenous opioids in the sympathetic ganglia and central nervous system Magnesium competes with calcium It reduces the release of neurotransmitters such as acetylcholine
Magnesiums ability to inhibit the release of acetylcholine contributes to its anticonvulsant properties Additionally blocking NMDA receptors contributes to its analgesic effects Additionally magnesiums ability to enhance the effects of local anesthetics has been studied By increasing the firing threshold in nerves and causing hyperpolarization magnesium enhances the effect of local anesthetics thereby improving nerve blockade This enhancement of nerve blockade is particularly evident when magnesium is added to agents such as bupivacaine 10 11
These interventional methods used to treat low back pain can be applied in combination There is not enough research on this subject
Sympathetically maintained pain including lumbar sympathetic ganglion block LSGB complex regional pain syndrome CRPS types I and II neuropathies such as postherpetic neuralgia stump or phantom limb pain diabetic polyneuropathy and ischemic pain from vascular insufficiency in the lower leg It is a widely applied procedure for diagnosing and managing diseases 8 The autonomic nervous system consists of sympathetic and parasympathetic departments As the name suggests blood supply to the lower extremity increases after lumbar sympathetic block This is useful in sympathetic system-mediated treatment of pain 9
The most important reason for adding fentanyl and magnesium as adjvams is to improve the quality of analgesia and provide analgesia for a longer period of time Both fentanyl and magnesium have the ability to modulate neurotransmitter release and affect neuronal excitability Fentanyl demonstrates the role of the sympathetic nervous system in modulating pain by increasing the effectiveness of endogenous opioids in the sympathetic ganglia and central nervous system Magnesium competes with calcium It reduces the release of neurotransmitters such as acetylcholine
Magnesiums ability to inhibit the release of acetylcholine contributes to its anticonvulsant properties Additionally blocking NMDA receptors contributes to its analgesic effects Additionally magnesiums ability to enhance the effects of local anesthetics has been studied By increasing the firing threshold in nerves and causing hyperpolarization magnesium enhances the effect of local anesthetics thereby improving nerve blockade This enhancement of nerve blockade is particularly evident when magnesium is added to agents such as bupivacaine 10 11
These interventional methods used to treat low back pain can be applied in combination There is not enough research on this subject
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None