Universität zu Köln

Heck, Vincent J., Himpe, Bastian, Kessler, Paul, Almajali, Asem, Prasse, Tobias, Schmidt, Sven and Rauschmann, Michael (2022). Feasibility of continuous epidural analgesia in patients with failed back surgery syndrome and spinal stenosis. J. Anesth., 36 (2). S. 246 - 254. TOKYO: SPRINGER JAPAN KK. ISSN 1438-8359

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Abstract

Purpose The purpose of this study was to outline the feasibility of continuous epidural analgesia in the treatment of failed back surgery syndrome (FBSS) or spinal stenosis. Methods We queried our prospective collected institutional database to include all consecutive patients, who underwent continuous epidural analgesia with accompanying intensive physiotherapeutic exercise within a timeframe of 4 years. Patients suffered from FBSS or spinal stenosis; protocolled continuous epidural analgesia was planned for 4 days within the framework of an inpatient multimodal pain therapy concept. The instillation technique of the epidural catheter, the capability to attend in accompanying physiotherapy, and the peri-interventional complications were evaluated. Results 153 patients with an average age of 57.4 years (+/- 11.9) were enrolled in this study. 105 patients suffered from FBSS and 48 patients had spinal stenosis. Overall, 148 patients (96.7%) reported the pain reduction and were able to perform daily intensified physiotherapeutic exercise. There were no serious adverse events, neither infection nor bleeding, no cardiopulmonary complication or permanent neurological deficits. The most common side effect was neurological impairment, such as numbness, dysesthesia, or weakness of the lower limbs with complete regression after flow rate adjustment. Patients with FBSS were more likely to develop dysesthesia (p = 0.007). Conclusions Continuous epidural analgesia is feasible in patients with FBSS or spinal stenosis. This treatment enables extensive physiotherapeutic treatment even in patients with severe pain conditions and can be considered as an alternative to epidural injections. An increased complication rate in comparison to short-term perioperative or perinatal application was not observed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Heck, Vincent J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Himpe, Bastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Kessler, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Almajali, Asem UNSPECIFIED UNSPECIFIED UNSPECIFIED Prasse, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Rauschmann, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-677535
DOI:	10.1007/s00540-022-03039-6
Journal or Publication Title:	J. Anesth.
Volume:	36
Number:	2
Page Range:	S. 246 - 254
Date:	2022
Publisher:	SPRINGER JAPAN KK
Place of Publication:	TOKYO
ISSN:	1438-8359
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMPLICATIONS; INJECTIONS; PAIN; ANESTHESIA Multiple languages Anesthesiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67753