The Role of Nerve Blocks in Patients Older Than 75 years |
Je-On Park , Sang Dae Kim , Dong Jun Lim, Tae Hyung Cho , Jung Yul Park |
Department of neurosurgery, Korea University Ansan Hospital, Korea University School of Medicine, Ansan, Korea |
75세 이상의 고령환자에서 신경차단술의 역할 |
박제언ㆍ김상대ㆍ임동준ㆍ조태형ㆍ박정율 |
고려대학교 의과대학 안산병원 신경외과학교실 |
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Abstract |
Objective s: The goal of this study was to establish the role of nerve blocks for various pain syndromes, by demonstrating
the benefits and usefulness, in patients older than 75 years.
Methods A retrospective analysis was based on the data obtained from 136 patients with various spinal diseases,
75 years or more, who received nerve blocks for painful conditions between Mar. 2002 and Dec. 2006. Underlying
disorders for the painful conditions were spinal stenosis, degenerative disc disease, compression fracture, and facet
syndrome. Medial branch block, dorsal root ganglion block, gray ramus communicans nerve block were included
among various treatment options. All nerve blocks were performed after careful medical history taking and obtaining
an informed consent. All blocks were done in operating room with C-arm guidance and all patients were observed
more than 30 minutes before discharge from hospital. They were performed in a weekly basis with observation
of any side effects or complications. The outcome of pain procedures was analyzed by using Visual Analog Scale
(VAS) at baseline and 6 months following 2~3 nerve blocks. The number of nerve blocks was depended upon
the degrees and duration of pain relief and it was averaged 2.3 in numbers.
Results All patients tolerated procedures well. Significant pain relief seen at 6 months was noted in 109 patients
(80.1%) with initial VAS score 7.46, and post-block VAS score 2.48. None of these patients required other surgical
procedures during follow-up period. There were no major procedure related complications except few patients with
dizziness and transient numbness and/or weakness that were fully recovered after 1~2 hours (2.9%/injection).
Conclusions The results of this study, although representing only 6 months follow-up evaluation, the various
nerve block procedures are considered as safe and effective therapeutic options for even very old patients who
show unsatisfactory results to conservative managements including medications, physical therapy or other types
of treatments. |
Key Words:
Nerve blockㆍOld ageㆍSpinal disorderㆍBack painㆍPrognosis |
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