title: Lumbar epidural anesthesia in the treatment of discal lombosciatalgia: a comparative clinical study between methylprednisolone and methylprednisolone with levobupivacaine.
abstract: OBJECTIVE
  Lumbar epidural technique has been used in the treatment of lombosciatalgia since 1953. In most cases, methylprednisolone is used along with a local anesthetic, and it is not known whether the isolated use of methylprednisolone is equally effective in relieving symptoms. The objective of this study was to compare the efficacy of two different solutions--methylprednisolone with saline and methylprednisolone with levobupivacaine injected in the epidural space to heal lombosciatalgia secondary to lumbar herniated disk.
  
  
  METHODS
  Sixty individuals ASA I and II, of both genders, ages 18 to 65 years participated in this randomized, double-blind study over a period of one year. They underwent interlaminar lumbar epidural analgesia without radioscopic control to heal a lombosciatalgia and they were divided into two groups: G-M (methylprednisolone + saline) and G-M + L (methylprednisolone + levobupivacaine + saline) both at a volume of 10 mL. Diagnosis was based on history, physical exam, and imaging exam (MRI). The Visual Analogue Scale (VAS) was applied in a total of two blockades, 15 days apart.
  
  
  RESULTS
  A reduction in pain severity was observed in the methylprednisolone-levobupivacaine group, but without statistical significance.
  
  
  CONCLUSIONS
  The analgesic efficacy of the G-M + L solution was superior to that of the G-M solution in the treatment of discal lombosciatalgia regarding the shorter time to onset of analgesia, but this was not significant at the time of discharge, and both solutions were effective in the treatment of discal lombosciatalgia.
authors.affiliation: Universidade de São Paulo, Brazil.
authors.forename: Fátima Aparecida Emm Faleiros
authors.initials: FA
authors.lastname: Sousa
authors.forename: Orlando Carlos Gomes
authors.initials: OC
authors.lastname: Colhado
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications; D000077554:Levobupivacaine; D008161:Lumbosacral Region; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012585:Sciatica / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D000077554:Levobupivacaine; D008775:Methylprednisolone; D002045:Bupivacaine