ORIGINAL ARTICLES   Free access

Minerva Anestesiologica 2016 April;82(4):411-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

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.