Pain Management for low back Pain and Lumbosacral Radiculopathy

요통에 대한 통증관리

Since the introduction of epidural corticosteroid injections for the management of sciatica, lumbosacral radiculopathy has become one of the most common pain problems encountered by anesthesiologists. In order to function effectively, anesthesiologists should be able to: (1) recognize those syndromes which may respond to nerve block; (2) understand the pathophysiology of the conditions being treated and (3) be familiar with alternate therapeutic pathways for patients not responding to merre block. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production. The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The results are as follows: Excellent pain relieved group: 27 patients (25.5%) Good pain relieved group: 49 patients (46.1%) Fair pain relieved group: 15 patients(14.2%) Not effective group: 15 patients(14.2%).

경막외 천자는 마취과 의사는 누구나 쉽게 시행할 수 있는 수기이므로 요통으로 고생하는 많은 환자들중에 얼마만큼이라도 우리들의 손으로 치유하는 보람을 가졌으면 좋겠다. 또한 좀 더 요통치료에 대한 연구가 많았으면 한다.