Spinal kord yaralı hastalarda kronik santral ağrı ve spastisite için epidural midazolam uygulanımı
Küçük Resim Yok
Tarih
1997
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Dergi ISSN
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Spinal kord yaralı (SKY) hastalarda kronik ağrı ve spastisite, hem rehabilitasyon sürecini hem de hastanın yaşam kalitesini belirgin olarak etkiler. Son yıllarda intratekal ve epidural uygulanan midazolam'ın hayvanlarda ve insanlarda analjezik ve antispastik etki oluşturduğunun gösterilmesi, bu ajanın SKY hastalarda da kullanımını gündeme getirmiştir. Bu çalışmada hem santral ağrısı hem de spastisitesi olan 4 paraplejik hastaya lomber epidural kateter yoluyla (hasta kontrollü analjezi pompası kullanarak) 4 saatte bir 40 /ağ/kg midazolam, serum fizyolojik ile 10 ml'ye tamamlanarak verildi. Hastaların ağrıları vizüel analog skala ve face skala ile, spastisiteleri ise modifiye Ashworth skalası ile değerlendirildi. Hastalar en az iki hafta süreyle klinikte tutuldu ve tedavinin etkinliği gözlendi. Epidural midazolam'ın hem ağrıya hem de spastisiteye karşı etkili olduğu görülmekle beraber, analjezik etkinin daha belirgin ve daha uzun süreli sağlandığı hesaplandı. Hastaların hiçbirinde ciddi bir yan etki gözlenmedi. Sonuç olarak, SKY hastalarda santral ağrı ve/veya spastisite tedavisi için epidural kateter veya implantabl ilaç pompası ile midazolam verilmesini önermekteyiz.
In the patients with spinal cord injury (SCI) chronic pain and spasticity affect significantly both the efficacy of rehabilitation and the quality of life. Recently it was shown that intrathecally and epidurally administered midasolam has analgesic and antispastic effects in both animals and humans so that it constitutes an alterna¬tive to be used in patients with SCI, In this study, four paraplegics who suffered from chronic central pain and spasticity in their lower ex¬tremities were given midasolam 6 times daily (dose 40 Hg/kg dissolved in 10 ml normal saline) via lumbar epi¬dural catheter using pain management provider. Spas¬ticity was monitored by means of a modified Ashworth scale, and pain evaluation was performed by face scale and VAS. The patients were hospitalized at least for two weeks and were observed for the efficacy of the drug. Although epidural administration of midasolam re¬lieved both central pain and spasticity, it's efficacy on central pain was more pronounced. There were no sig¬nificant side effects in any patient. We propose that midasolam may be given by epidural catheter or implantahle drug pump for the treatment of central pain and/or spinal spasticity in spinal cord in¬jured patients.
In the patients with spinal cord injury (SCI) chronic pain and spasticity affect significantly both the efficacy of rehabilitation and the quality of life. Recently it was shown that intrathecally and epidurally administered midasolam has analgesic and antispastic effects in both animals and humans so that it constitutes an alterna¬tive to be used in patients with SCI, In this study, four paraplegics who suffered from chronic central pain and spasticity in their lower ex¬tremities were given midasolam 6 times daily (dose 40 Hg/kg dissolved in 10 ml normal saline) via lumbar epi¬dural catheter using pain management provider. Spas¬ticity was monitored by means of a modified Ashworth scale, and pain evaluation was performed by face scale and VAS. The patients were hospitalized at least for two weeks and were observed for the efficacy of the drug. Although epidural administration of midasolam re¬lieved both central pain and spasticity, it's efficacy on central pain was more pronounced. There were no sig¬nificant side effects in any patient. We propose that midasolam may be given by epidural catheter or implantahle drug pump for the treatment of central pain and/or spinal spasticity in spinal cord in¬jured patients.
Açıklama
Anahtar Kelimeler
Rehabilitasyon, Romatoloji
Kaynak
Romatoloji ve Tıbbi Rehabilitasyon Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
4
