RU1780751C - Method for treating vertebrogenous paint syndrome - Google Patents

Abstract

The invention relates to medicine, in particular to neurology. The aim of the proposed method is to optimize the processes of sanogenesis, increase efficiency and reduce the cost of treatment, for which a patient with neurological manifestations of lumbar osteochondrosis is given an epidural solution of sodium bicarbonate.

Description

The invention relates to medicine, in particular to neurology, and can be used to treat vertebral pain syndrome in the lumbosacral localization.

The following methods of treating pain of the lumbosacral localization are known: along with traction, oral non-narcotic analgesics or anesthetic anti-inflammatory drugs are prescribed in combination with diuretics, peripheral vasodilators, venotonic drugs, antihistamines. Paravertebral novocaine blockades, diadynamic and sinusoidally modulated currents, and ultrasound have similar effects, but all these methods have a wide range of contraindications, have toxic and allergenic side effects, and do not always lead to a lasting effect.

Closest to the claimed is the method of epidural administration of drugs according to Kathleen (1910) in

modifications of V.K. Romanov. The method is as follows. The patient occupies a lying position on the sore side with legs bent and brought to the stomach. After thorough skin disinfection, the lower sacral opening located between the coccyx horns is palpated. At this point, with a needle, intracutaneous anesthesia of 2-3 ml of a 1% solution of novocaine is performed, after which a needle with a length of 5-6 cm (preferably with a shorter section than usual, which avoids injury to the epidural fiber veins), puncture the sacro- coccygeal membrane. Then, the needle is guided by the cranial and inserted into the sacral canal by 4-5 cm. Having retreated to the estimated distance, a test aspiration is carried out with a syringe and, making sure that there is no leakage of cerebrospinal fluid or blood, they begin to administer 0.5-1% novocaine solution at a rate of 20 ml in 1 min. The total amount of novocaine administered in the solution is 50-70 ml. At the end of the blockade, the patient is sent to the ward and lies in bed for about an hour with B

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Mr. side. This method reduces pain by 12-24 hours. But the indicated technical solution has a number of disadvantages: the instability of the effect, the occurrence of a general resorption reaction when novocaine enters the bloodstream, and allergic reactions.

The aim of the claimed method for treating vertebrogenic pain is to increase the therapeutic efficacy of treatment by optimizing the processes of sanogenesis.

The goal is achieved by the fact that sodium bicarbonate is supplied directly to the zone of disc-radicular conflict, which leads to a positive effect on the intimate parts, the pathogenesis of the pain syndrome - local ischemia and acidosis, and the normalization of the acid-base state directly in the lesion site. Inhibition of the local autosensitizing process, a decrease in the local autosensitizing process, and a decrease in the formation of adhesions in the zpidural space are also expected.

The proposed epidural administration of a 4-5% sodium bicarbonate solution of 40-60 ml once every 3 days does not technically differ from the above method. As a result of carrying out 2-3 procedures, it was possible to significantly reduce the severity of the pain syndrome; its decrease was smooth and uniform, lasting for 36-24 hours, and most importantly, persistent.

The use of epidural administration of sodium bicarbonate for the treatment of vertebrogenic pain syndrome provides a new positive effect: a longer and more persistent reduction in pain, a reduction in the patient’s hospital stay by 2 days, a more stable remission, the absence of allergic reactions, and lower treatment costs.

An example implementation of the method:

Patient A.I. Turkov, 34 years old, was admitted to the clinic of neurological diseases of the Military Medical Academy on December 4, 89, complaining of constant sharp pain in the lower back, aggravated by movement, which led to the patient being immobilized. Before admission, he was treated on an outpatient and inpatient basis (24 days) using analgesics, B vitamins, electrophoresis, massage. On admission: Right-sided scoliosis of the 3rd degree, antalgic tension of the long muscles of the back, decrease in the right Achilles reflex with the strength of the extensors of the foot and

thumb, bilateral symptom of Lasegue 3 degrees. Diagnosis: Acute pronounced radiculitis L-5 on the right. Against the background of conventional treatment, including analgesics, vasodilators and

decongestants, ultrasound, traction; 2 epidural procedures were performed with 50 and 60 ml of 4% sodium bicarbonate solution. The pain syndrome stopped, the patient was discharged after 18 days of recovery, and upon discharge, the asymmetry of the Achilles reflexes was insignificant. Inspection in six months - no complaints.

The claimed method allows

reduce pain vertebrogenic syndrome in the lumbosacral localization in 6-10 days, reduce the patient’s stay in the clinic, and avoid side effects. phenomena (allergic reactions, a general resorptive reaction when novocaine enters the bloodstream, toxic effects), is aimed at creating conditions in the body for self-healing, is economically beneficial, since sodium bicarbonate is cheaper

analgesics and novocaine.

The method is technically relatively simple, does not require additional conditions and equipment, can be quickly introduced into the daily practice of neuropathologists.

Claims (1)

SUMMARY OF THE INVENTION A method for treating vertebrogenic pain by epidural administration of drugs, characterized in that, in order to increase the therapeutic effectiveness of treatment by optimizing the processes of sanogenesis, sodium bicarbonate solution is administered.