Effects of Continuous Epidural Injection of Dexamethasone on Blood Glucose, Blood Lipids, Plasma Cortisol and ACTH in Patients With Neuropathic Pain

Abstract

Objective: To study the effects of continuous epidural injection of dexamethasone on blood glucose, blood lipids, plasma cortisol, and adrenocorticotropic hormone (ACTH) in patients with neuropathic pain.Methods: Thirty patients with cervical spondylotic radiculopathy, lumbar disc herniation, herpes pain or postherpetic neuralgia were randomly divided into three groups and were treated with different doses of epidural injection of dexamethasone (Group S with a concentration of 25 μg/mL; Group M with a concentration of 50 μg/mL; Group L with a concentration of 100 μg/mL). Epidural catheterization placement was guided by computed tomography (CT), and was connected to the analgesic pump for 10 days. Visual Analog Score (VAS), fasting blood glucose (FBG), total cholesterol (CHOL), triglyceride (TG), 2 h postprandial blood glucose (2hPG) and the concentrations of cortisol, ACTH were measured before injection (T0), 2, 4, 6, 8, and 10 days during injection (D2, D4, D6, D8, D10), and 7, 14, 21, 28 days (W1, W2, W3, W4) after injection.Results: During and after the treatment, VAS score was significantly decreased, and group M and L had the lowest VAS score. The concentrations of cortisol and ACTH were significantly lower during the treatment, but all of them recovered to the normal level after stopping the injection. The treatment did not affect the CHOL and TG concentrations.Discussion: Epidural injection of dexamethasone at the concentration of 50 μg/mL is recommended for patients with neuropathic pain because of its good analgesic effect and less adverse effect on blood glucose, plasma cortisol, and ACTH.

Electroacupuncture Attenuates Neuropathic Pain in a Rat Model of Cervical Spondylotic Radiculopathy: Involvement of Spinal Cord Synaptic Plasticity

“…Neuropathic pain (NP) is characterized by a long course, high incidence, and high recurrence rate, which are the main symptoms of CSR. 4 NP refers to chronic pain related to neurological system lesions or diseases with a major impact on quality of life and results in a significant financial burden. 5 The treatment of NP is often challenging, with only a small percentage of patients benefiting from several interventions.…”

Emerging roles of circular RNAs in neuropathic pain

“…Although the exact prevalence of neuropathic pain varies from country to country, it has been estimated that up to 10% of the general population is afflicted with this potentially disabling condition 12‐16 . Different medical treatments (eg tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, opioids, lidocaine) have been used clinically for the treatment of neuropathic pain, but up to half of the patients with neuropathic pain are refectory to these drugs 17‐22 . The ineffectiveness of medical interventions arises partly due to the poorly understood molecular mechanism of neuropathic pain.…”

“… 12 , 13 , 14 , 15 , 16 Different medical treatments (eg tricyclic antidepressants, selective serotonin noradrenaline reuptake inhibitors, opioids, lidocaine) have been used clinically for the treatment of neuropathic pain, but up to half of the patients with neuropathic pain are refectory to these drugs. 17 , 18 , 19 , 20 , 21 , 22 The ineffectiveness of medical interventions arises partly due to the poorly understood molecular mechanism of neuropathic pain. Both peripheral and central sensitization are known to be implicated in the pathogenesis of neuropathic pain.…”