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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2016 Aprile;82(4):411-8
Treatment of chronic cervicobrachial pain with periradicular injection of meloxicam
Lucia AURINI 1, 2, Battista BORGHI 2, 3, Paul F. WHITE 2, 4, 5, Andrea TOGNÙ 6, Barbara ROSSI 2, Greta FINI 2, Pierfrancesco FUSCO 7, Massimiliano MOSCA 8, Raffaele BORGHI 3, 8 ✉
1 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; 2 Research Unit of Anesthesia and Pain Therapy, Rizzoli Orthopedic Institute, Bologna, Italy; 3 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; 4 Departments of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, CA, USA; 5 White Mountain Institute, The Sea Ranch, CA, USA; 6 Department of Anaesthesia and Postoperative Intensive Care, Istituto Ortopedico Rizzoli, Bologna, Italy; 7 Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L’Aquila, L’Aquila, Italy; 8 1st Orthopedic Clinic, Rizzoli Orthopedic Institute, Bologna, Italy
BACKGROUND: Cervicobrachial pain (CBP) is often resistant to conventional oral analgesics. We hypothesized that the periradicular injection of meloxicam would produce a significant reduction in their intractable CBP. The secondary objective was to assess the impact of the treatment on functional recovery.
METHODS: 48 patients with persistent CBP (>3 months of duration) despite multimodal analgesic therapy received 1-3 periradicular injections of meloxicam, 5-20 mg, at the dermatomal level(s) corresponding to their pain symptoms. Pain level (0=none to 10=severe), rescue analgesics, and functional activity were recorded at baseline and for 90d after the last injection. The injection was repeated if the pain score remained >3 or paresthesia persisted.
RESULTS: The mean pain score was reduced from a baseline of 8.9 (±1) to 1.7 (±2.2) at 90 days after the last meloxicam injection. Following meloxicam treatment(s), only 13% of the patients required oral analgesic rescue medication. All patients increased their functional activity level.
CONCLUSIONS: Cervical periradicular injection of meloxicam reduced CBP by 81% at 90-day follow-up and also improved functional recovery.