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MINERVA ANESTESIOLOGICA

Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Anestesiologica 2018 Feb 05

DOI: 10.23736/S0375-9393.18.12221-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Treatment of recent onset low back pain with periradicular injections of meloxicam: a randomized, double blind, placebo controlled cross-over study

Battista BORGHI 1, 2, Lucia AURINI 3 , Paul F. WHITE 4, 5, 6, 7, Andrea TOGNÙ 3, Barbara ROSSI 8, Greta FINI 2, Paola RUCCI 1, Tiziana GREGGI 9, Raffaele BORGHI 10

1 Department of Biomedical and Neuromotor Sciences University of Bologna, Bologna, Italy; 2 Research Unit of Anaesthesia and Pain Therapy, Rizzoli Orthopedic Institute, Bologna, Italy; 3 Unit of Anaesthesia and Pain Therapy, Rizzoli Orthopedic Institute, Bologna, Italy; 4 Department of Anesthesiology at Cedars Sinai Medical Center in Los Angeles, CA, USA; 5 Rizzoli Orthopedic Institute, Bologna, Italy; 6 Phoenix Thera-lase Systems, Dallas, TX, USA; 7 White Mountain Institute in The Sea Ranch, Los Angeles, CA, USA; 8 Department of Medical and Surgical Sciences, Anesthesia, University of Bologna, Bologna, Italy; 9 Spine Deforming Surgery Division Rizzoli Orthopedic Institute, Bologna, Italy; 10 2nd Orthopedic Clinic, Rizzoli Orthopedic Institute, Bologna, Italy


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BACKGROUND: Low back pain (LBP) is a common and costly illness. This randomized, double-blind, placebo-controlled, cross-over study tested the hypothesis that periradicular injections of meloxicam would reduce LBP and improve physical activity compared to a saline injection at 3 months follow-up.
METHODS: After IRB approval, 80 consenting patients suffering LBP of <6 months duration were randomly assigned to the Control (C-group, n=40, receiving 10ml of saline) or the Meloxicam (M- group, n=40, receiving 10 mg in 10 ml saline). If the pain numeric rating score (NRS) at 24hours remained >50% of the pre-treatment score, the patient was crossed-over to the other group. A successful treatment was NRS <3 at 3 months follow-up. Secondary outcome measures which were assessed included work-absence, physical-assistance, physical-activities limitations and pain-related insomnia.
RESULTS: The baseline NRS was 9.3 (95% CI 8.9-9.7) in the C-group and 9.2 (95% CI 8.8-9.6) in the M-group. At the 24hours follow-up after the initial treatment, the mean NRS was 6.3 (95% CI 5.4- 7.2) in the C-group vs 3.5 (95% CI 2.6-4.4) in the M-group (p<0.05). The number of cross-over cases was significantly higher in the C-group (n= 31, 77.5% vs. n=5, 12.5%, p<0.001). At the 3months follow- up, 66 patients (35+31) were allocated in the M-group and 54 (82%) reported NRS score <3, while only 14 (9+5) patients remained in the C-group and 8 patients had NRS <3.
CONCLUSIONS: Periradicular injection of meloxicam is an effective analgesic treatment for acute/subacute LBP. This novel use of meloxicam also leads to an improvement in the level of physical activity at the 3months follow-up.


KEY WORDS: Low Back - Pain - Periradicular - Meloxicam

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Publication History

Article first published online: February 5, 2018
Manuscript accepted: February 2, 2018
Manuscript revised: January 22, 2018
Manuscript received: June 5, 2017

Per citare questo articolo

Borghi B, Aurini L, White PF, Tognù A, Rossi B, Fini G, et al. Treatment of recent onset low back pain with periradicular injections of meloxicam: a randomized, double blind, placebo controlled cross-over study. Minerva Anestesiol 2018 Feb 05. DOI: 10.23736/S0375-9393.18.12221-8

Corresponding author e-mail

lucia.aurini@ior.it