Bước Đầu Sử Dụng Các Kỹ Thuật Giảm Đau Can Thiệp

THE INITIAL USE OF INTERVENTIONAL THERAPIES IN PAIN MANAGEMENT

Dr. Do Thanh Huy

Can Tho University of Medicine and Pharmacy

Đặt vấn đềIntroduction

Classical ladder

Classical ladder is too short???

New WHO analgesic ladder

Phòng khám đau-cơ xương khớpPain-musculoskeletal unit

From october/2012. we follow up first 43 cases of interventional techniques in pain management in Can Tho

Tiêm steroid ngoài màng cứng-16 trường hợp

Epidural steroid injections-16 cases

Cervical epidural steroid injections for cervical radiculopathy

Thoracic epidural steroid injection for postherpetic neuralgia

1 case

Lumbar radiculopathy(11 cases)

Spinal stenosis(5cases)

Cervical radiculopathy(1case)

Postherpetic neuralgia(1case)

Cervical medial branch block for cervical facet syndrome(2cases)

Lumbar medial branch block for lumbar facet syndrome

Injection of the temporomandibular joint(1case)

Injection of trigger thumb(1case)

Injection for de Quervain’s tenosynovitis(3case)

Injection of trigger finger(2case)

Injection for tennis elbow(4cases)

Injection for the subdeltoid bursa

Hiệu quả đến đâu?Follow up effective: interview patients (by mobile phone or follow-up examination)

Before injection

After injection

Before injection

After two weeks injection lumbar radiculopathy

Bằng chứng?

Phân loại bằng chứngQuality of evidence

Evidence for cervical radicular pain

Pain free

Evidence for cervical facet

Pain free

Evidence for lumbar radiculopathy

1 patient with LR required surgery after two weeks and 3 patients with LR required second injection

Evidence for lumbar facet pain

3/43(7%) fair satisfaction

Evidence for post-herpetic neuralgiafair satisfaction

Evidence for musculoskeletal injections Pain free

100%

Kết luận