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Bhatia A, Bril V, Brull RT, et al. Analgesic effect of perineural local anesthetics, steroids, and conventional medical management for trauma and compression-related peripheral neuropathic pain: a retrospective cohort study. Pain Rep. 2021;6(2):e945doi: 10.1097/PR9.0000000000000945.
Bhatia, A., Bril, V., Brull, R. T., Perruccio, A. V., Wijeysundera, D. N., Lau, J., Gandhi, R., Mahomed, N., & Davis, A. M. (2021). Analgesic effect of perineural local anesthetics, steroids, and conventional medical management for trauma and compression-related peripheral neuropathic pain: a retrospective cohort study. Pain reports, 6(2), e945. https://doi.org/10.1097/PR9.0000000000000945
Bhatia, Anuj, et al. "Analgesic effect of perineural local anesthetics, steroids, and conventional medical management for trauma and compression-related peripheral neuropathic pain: a retrospective cohort study." Pain reports vol. 6,2 (2021): e945. doi: https://doi.org/10.1097/PR9.0000000000000945
Bhatia A, Bril V, Brull RT, Perruccio AV, Wijeysundera DN, Lau J, Gandhi R, Mahomed N, Davis AM. Analgesic effect of perineural local anesthetics, steroids, and conventional medical management for trauma and compression-related peripheral neuropathic pain: a retrospective cohort study. Pain Rep. 2021 Jul 13;6(2):e945. doi: 10.1097/PR9.0000000000000945. eCollection 2021. PMID: 34278164; PMCID: PMC8280075.
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Pain Rep. 2021 Jul 13;6(2):e945. doi: 10.1097/PR9.0000000000000945. eCollection 2021.

Analgesic effect of perineural local anesthetics, steroids, and conventional medical management for trauma and compression-related peripheral neuropathic pain: a retrospective cohort study.

Pain reports

Anuj Bhatia, Vera Bril, Richard T Brull, Anthony V Perruccio, Duminda N Wijeysundera, Johnny Lau, Rajiv Gandhi, Nizar Mahomed, Aileen M Davis

Affiliations

  1. Department of Anesthesiology and Pain Medicine and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
  2. Department of Anesthesiology and Pain Management, Toronto Western Hospital, Toronto, ON, Canada.
  3. Neuromuscular Section, Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
  4. Neuromuscular Section, Division of Neurology, University Health Network, Toronto, ON, Canada.
  5. Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
  6. Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada.
  7. Division of Health, Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
  8. Department of Anesthesiology, University of Toronto, Toronto, ON, Canada.
  9. Department of Anesthesia, St. Michael's Hospital and Li Ka Shing, Knowledge Institute, Toronto, ON, Canada.
  10. Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
  11. Foot and Ankle Program, Toronto Western Hospital, Toronto, ON, Canada.
  12. Arthritis Program, Altum Health, Toronto Western Hospital, Toronto, ON, Canada.
  13. Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
  14. Department of Physical Therapy and Surgery, Graduate Department of Rehabilitation Science and Institute of Health Policy, Management and Evaluation and Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

PMID: 34278164 PMCID: PMC8280075 DOI: 10.1097/PR9.0000000000000945

Abstract

INTRODUCTION: Trauma and compression are common causes of peripheral neuropathic pain (NP) refractory to conventional medical management (CMM). The role of perineural interventions in relieving this type of pain is unclear.

OBJECTIVES: The objectives of this retrospective study were to determine the analgesic benefits of adding a combination of perineural local anesthetic and steroids (LA-S) to CMM compared with CMM alone in patients who had moderate-to-severe refractory NP after trauma to the ankle and the foot.

METHODS: Health care records of 60 patients in exposed (3 injections of perineural LA-S at weekly intervals with CMM) and 60 in unexposed (CMM) cohorts were reviewed. Data on patient characteristics, pain, and mental and physical function were extracted at baseline and at the postintervention follow-up. Data were analyzed to evaluate analgesic benefit from the study interventions and the impact of baseline characteristics.

RESULTS: Perineural LA-S with CMM cohort had lower pain numerical rating scale scores at 1 to 3 months after the intervention as compared to the CMM alone cohort (5.50 [interquartile range 4.00-7.00] and 7.00 [interquartile range 5.00-8.00], respectively;

CONCLUSION: Perineural local anesthetic and steroid injections do not confer an analgesic benefit for trauma- or compression-related peripheral NP.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

Keywords: Compression; Perineural local anesthetics and steroids; Peripheral neuropathic pain; Trauma

Conflict of interest statement

The authors have no conflicts of interest to declare. This research was supported by the Outcomes Measurement and Research Division of Altum Health, University Health Network. The authors would like t

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