All funding sources of the submitted work were supported by Baskent University.
Management of Neuropathic Pain with Methylprednisolone at the Site of Nerve Injury
Article first published online: 7 FEB 2012
Wiley Periodicals, Inc.
Volume 13, Issue 3, pages 443–451, March 2012
How to Cite
Eker, H. E., Cok, O. Y., Aribogan, A. and Arslan, G. (2012), Management of Neuropathic Pain with Methylprednisolone at the Site of Nerve Injury. Pain Medicine, 13: 443–451. doi: 10.1111/j.1526-4637.2011.01323.x
Conflict of interest: None.
- Issue published online: 16 MAR 2012
- Article first published online: 7 FEB 2012
- Peripheral Nerve Blocks;
- Neuropathic Pain
Objective. Peripheral nerve blocks with methylprednisolone may provide effective pain therapy by decreasing ectopic neuronal discharge and the release of local inflammatory mediators at the site of nerve injury. In this study, we aimed to compare the efficacy of lidocaine alone with a combination of depo-methylprednisolone plus lidocaine in the management of neuropathic pain due to peripheral nerve damage.
Design. Randomized, double-blind comparator trial
Setting. Group control (N = 44) received 0.5% lidocaine and group methylprednisolone (N = 44) received 80 mg depo-methylprednisolone + 0.5% lidocaine proximal to the site of nerve injury with a total amount of 10–20 mL solution according to the type of peripheral nerve block with nerve stimulator.
Outcome Measures. Demographic data, preblock numerical rating scales (NRSs), the Leeds assessment of neuropathic symptoms and signs (LANSS0) score, accompanying symptoms, and analgesic requirements were recorded. Postblock NRS scores were noted following peripheral nerve block and after 3 months. LANSS1, accompanying symptoms, and analgesic requirements were also reevaluated 3 months after the injection.
Results. Demographic data, preblock NRS (8 ± 1.5 and 8.1 ± 1.2, respectively), postblock NRS (2.1 ± 1.2 and 2.4 ± 1.4, respectively), LANSS0 (18.4 ± 2.2 and 18.2 ± 2.1, respectively), and accompanying symptoms were comparable between groups. Scores for the methylprednisolone group were significantly improved at 3-month postblock for NRS (2 ± 1.4 vs 5.2 ± 1.7) and LANSS1 scores (4.14 ± 2.7 vs 14.1 ± 2.8), accompanying symptoms, and analgesic requirements (P < 0.0001).
Conclusions. Our results suggest that peripheral nerve block with 80 mg depo-methylprednisolone plus 0.5% lidocaine provides effective management in the treatment of neuropathic pain due to peripheral nerve damage.