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논문 기본 정보

자료유형
학술저널
저자정보
Guen Young Lee (Chung-Ang University Gwangmyeong Hospital) Joon Woo Lee (Seoul National University Bundang Hospital) Eugene Lee (Seoul National University Bundang Hospital) Jin S. Yeom (Seoul National University Bundang Hospital) Ki-Jeong Kim (Seoul National University Bundang Hospital) Hyung-Ik Shin (Seoul National University College of Medicine) Heung Sik Kang (Seoul National University Bundang Hospital)
저널정보
대한통증학회 The Korean Journal of Pain The Korean Journal of Pain 제35권 제3호
발행연도
2022.7
수록면
336 - 344 (9page)
DOI
10.3344/kjp.2022.35.3.336

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Background: The U.S. Food and Drug Administration has prohibited epidural steroid injection (ESI) with particulate steroids. Thus, this study aimed to compare the efficacy and safety of ESI with two nonparticulate steroids, dexamethasone and betamethasone. Methods: The eligible patients (n = 600) who received ESI (0 week) with dexamethasone (ESI-dexa) or betamethasone (ESI-beta) had follow-up visits at 2, 4, and 8 weeks with a phone interview at 12 weeks. The primary endpoint was the proportion of effective responders without pain or who were much improved at 2 weeks. The secondary endpoints were the proportion of crossover injections at 2 weeks; changes in the visual analog scale (VAS) and disability index scores at 2, 4, and 8 weeks; the number of additional ESIs in 12 weeks; the number of participants having spinal surgery, as well as the incidence of adverse events over the 12 weeks. Results: The proportion of effective responders at 2 weeks was not different between ESI-beta (72/216, 33.3%) and ESI-dexa (63/200, 31.5%; P = 0.670). Adverse events were more common with ESI-dexa (40/200, 20.0%) than with ESI-beta (24/216, 11.1%; P = 0.012). VAS scores decreased more with ESI-beta than with ESI-dexa at 2 weeks (difference, 0.35; P = 0.023) and 4 weeks (difference, 0.42; P = 0.011). The disability score improved significantly more with ESI-beta compared with ESI-dexa at 2 weeks (difference, 3.37; P = 0.009), 4 weeks (difference, 4.01; P = 0.002), and 8 weeks (difference, 3.54; P = 0.007). Conclusions: Betamethasone would be more appropriate for ESI.

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