Uso de corticosteróides por via peridural nas síndromes dolorosas lombares

Abstract

RESUMO

Interventional analgesic block in a dog with cauda equina syndrome. Case report

“…After initial evaluations and data collection, the animal was referred to the operating room for an interventionist analgesic blockade. The technique chosen in this study was based on the data observed in humans 12 and also on the difficulty of the tutor in adhering to the conservative treatment with oral anti-inflammatory because it is a herding dog whose dwelling in a rural area would interfere with the administration of the drug. Thus, electro stimulation-guided epidural administration combining dexamethasone (4mg) 13 , bupivacaine 0.125% (0.22mL.…”

“…Some authors believe that small volumes of the solution are insufficient to reach the ventral aspect of the epidural space. However, other authors believe that the effect of the corticosteroid is independent of the volume injected but is due to the closest possible administration to the affected site 12 .…”

“…In the present report, the remission of clinical signs associated with pain and neurological components were solved with a single injection of the proposed combination. In humans, some patients respond well to the second or third epidural corticosteroid injection 12 . However, there are no reports of repeated injections into companion animals.…”

“…In humans, the use of fluoroscope has gained prominence in the last decade and has been used in almost all interventionist blockades. The wide clinical epidural use of corticosteroids in humans is generally related to the relief of pain syndromes resulting from inflammation of the neural structures of the epidural and perineural spaces 12 , which may be used for low back pain, sciatic pain, sacral pain, radicular pain, radiculopathy, lumbosciatalgy, nerve root compression, protrusion, prolapse or disc hernia and lumbar canal stenosis. Thus, it is valid the discussion about the epidural use of corticosteroids in these syndromes mentioned in dogs and cats since the result is likely to be similar to those obtained in humans.…”

Síndrome do piriforme

“…al. 12 consideram que a dor isquiática, unilateral ou bilateral, na maioria das vezes tem início na porção proximal da coxa e alcança o pé homolateral, podendo ser acompanhada ou não de déficit motor e/ou sensitivo. O exame físico pode denotar dor e parestesia na região glútea e trajeto isquiático, sendo exacerbada pela flexão do quadril combinada com a sua rotação externa e abdução ativa (sinal de Pace e Nagle) 25 ou rotação interna e adução passiva, com a coxa em extensão (sinal de Frieberg) 25,26 .…”