Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine?
Epidural injections (EI) of glucocorticoids (GC), the so-called blockades, are frequently recommended a very effective and most modern treatment for nonspecific back pain and lumbar ischialgia. However, EI of drugs (local anesthetics (LA)) for back pain relief has been practiced ever since 1901 when...
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IMA-PRESS LLC
2016-09-01
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| Series: | Современная ревматология |
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| Online Access: | https://mrj.ima-press.net/mrj/article/view/707 |
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| author | A. E. Karateev |
| author_facet | A. E. Karateev |
| author_sort | A. E. Karateev |
| collection | DOAJ |
| description | Epidural injections (EI) of glucocorticoids (GC), the so-called blockades, are frequently recommended a very effective and most modern treatment for nonspecific back pain and lumbar ischialgia. However, EI of drugs (local anesthetics (LA)) for back pain relief has been practiced ever since 1901 when it was first used by the French physicians J.F. Sicard and F. Cathelin, i.e. it belongs to the oldest therapeutic procedures. Moreover, experts' opinions as to the therapeutic value of EI of GC are rather contradictory. The data of a large number of clinical trials fail to confirm the unambiguous advantage of epidural GC used in combination with LA as compared to the effect of the latter only. According to a number of experts, the effect of EI of GC is only slightly better than that of placebo (physiologic saline) and little affects long-term treatment results. Epidural GC may result in rare but very serious, life-threatening complications. Obviously, this method should be used, only after carefully weighing its potential benefits and risks. In any case, EI of GC should not be considered as an alternative to other pharmacological and nonpharmacological therapies. |
| format | Article |
| id | doaj-art-d9a05e8ce495451dabfc4dd75625009c |
| institution | DOAJ |
| issn | 1996-7012 2310-158X |
| language | Russian |
| publishDate | 2016-09-01 |
| publisher | IMA-PRESS LLC |
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| series | Современная ревматология |
| spelling | doaj-art-d9a05e8ce495451dabfc4dd75625009c2025-08-20T03:20:59ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2016-09-01103879410.14412/1996-7012-2016-3-87-941994Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine?A. E. Karateev0V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522Epidural injections (EI) of glucocorticoids (GC), the so-called blockades, are frequently recommended a very effective and most modern treatment for nonspecific back pain and lumbar ischialgia. However, EI of drugs (local anesthetics (LA)) for back pain relief has been practiced ever since 1901 when it was first used by the French physicians J.F. Sicard and F. Cathelin, i.e. it belongs to the oldest therapeutic procedures. Moreover, experts' opinions as to the therapeutic value of EI of GC are rather contradictory. The data of a large number of clinical trials fail to confirm the unambiguous advantage of epidural GC used in combination with LA as compared to the effect of the latter only. According to a number of experts, the effect of EI of GC is only slightly better than that of placebo (physiologic saline) and little affects long-term treatment results. Epidural GC may result in rare but very serious, life-threatening complications. Obviously, this method should be used, only after carefully weighing its potential benefits and risks. In any case, EI of GC should not be considered as an alternative to other pharmacological and nonpharmacological therapies.https://mrj.ima-press.net/mrj/article/view/707nonspecific back painlumbar ischialgiainterventional methodsepidural injectionsglucocorticoidslocal anestheticsadverse reactions |
| spellingShingle | A. E. Karateev Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? Современная ревматология nonspecific back pain lumbar ischialgia interventional methods epidural injections glucocorticoids local anesthetics adverse reactions |
| title | Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? |
| title_full | Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? |
| title_fullStr | Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? |
| title_full_unstemmed | Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? |
| title_short | Epidural blockades using glucocorticoids: As to how the principles of evidence-based medicine? |
| title_sort | epidural blockades using glucocorticoids as to how the principles of evidence based medicine |
| topic | nonspecific back pain lumbar ischialgia interventional methods epidural injections glucocorticoids local anesthetics adverse reactions |
| url | https://mrj.ima-press.net/mrj/article/view/707 |
| work_keys_str_mv | AT aekarateev epiduralblockadesusingglucocorticoidsastohowtheprinciplesofevidencebasedmedicine |