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The role of pharmacological tests in patients with failed back surgery syndrome
open access
Abstract
Material and methods. The study population consists of 19 consecutive patients suffering from failed back surgery syndrome. Patients were administered analgetic drugs with a known mechanism of action intravenously (lidocaine, ketoprofen, tramadol, fentanyl, metamizole) and placebo. Before and after each drug administration patients rated their pain severity based on the VAS scale and reported adverse events.
Results. A very good result (≥ 50% reduction of pain intensity) was achieved only in 4 patients (21.1%). Additionally the satisfactory result (≥ 30% reduction of pain intensity) was achieved in 8 patients (42.1%). Fentanyl turned out to be the most effective drug, however its efficacy was low. Fentanyl elicited a 30% reduction of pain severity in 31.3% of patients and 50% reduction of pain severity only in 18.8% of patients.
Conclusions. Pharmacotherapy is effective only in a small number of patients. Use of target pharmacotherapy (an effective drug based on pharmacological tests) in combination with other therapeutic methods (central and peripheral blocks, psychotherapy, neuromodulation, rehabilitation) appears to be the best approach.
Abstract
Material and methods. The study population consists of 19 consecutive patients suffering from failed back surgery syndrome. Patients were administered analgetic drugs with a known mechanism of action intravenously (lidocaine, ketoprofen, tramadol, fentanyl, metamizole) and placebo. Before and after each drug administration patients rated their pain severity based on the VAS scale and reported adverse events.
Results. A very good result (≥ 50% reduction of pain intensity) was achieved only in 4 patients (21.1%). Additionally the satisfactory result (≥ 30% reduction of pain intensity) was achieved in 8 patients (42.1%). Fentanyl turned out to be the most effective drug, however its efficacy was low. Fentanyl elicited a 30% reduction of pain severity in 31.3% of patients and 50% reduction of pain severity only in 18.8% of patients.
Conclusions. Pharmacotherapy is effective only in a small number of patients. Use of target pharmacotherapy (an effective drug based on pharmacological tests) in combination with other therapeutic methods (central and peripheral blocks, psychotherapy, neuromodulation, rehabilitation) appears to be the best approach.
Keywords
pharmacological tests; failed back surgery syndrome
About this articleTitle
The role of pharmacological tests in patients with failed back surgery syndrome
Journal
Advances in Palliative Medicine
Issue
Vol 4, No 1 (2005): Polish Palliative Medicine
Pages
3-10
Published online
2005-01-19
Page views
744
Article views/downloads
5408
Bibliographic record
Advances in Palliative Medicine 2005;4(1):3-10.
Keywords
pharmacological tests
failed back surgery syndrome
Authors
Anna Wrzosek
Beata Sobkowicz
Wojciech Popiela
Jan Dobrogowski
Jerzy Wordliczek