Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial.
Study Goal
The researchers aimed to determine whether magnesium sulfate could enhance the effectiveness and prolong the therapeutic duration of epidural steroid injections for chronic radicular pain.
Results Summary
Magnesium significantly reduced pain intensity, disability, and analgesic consumption over a 6-month period, outperforming both the control and dexmedetomidine groups by the end of the study.
Population
90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse unresponsive to conservative treatment for 12 weeks.
Effective Dosage
200 mg magnesium sulfate (single dose, epidural injection).
Duration
Single intervention with follow-up assessments at 1 week, 1, 3, and 6 months.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
magnesium sulfate | decrease | pain | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #1 |
magnesium sulfate | decrease | disability | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #2 |
magnesium sulfate | decrease | analgesic consumption | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #3 |
dexmedetomidine | decrease | pain | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #4 |
dexmedetomidine | decrease | disability | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #5 |
dexmedetomidine | decrease | analgesic consumption | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #6 |
magnesium sulfate | decrease | pain scores | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | demonstrated significant improvement | #7 |
magnesium sulfate | decrease | Modified Oswestry Disability Index (MODI) | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | demonstrated significant improvement | #8 |
magnesium sulfate | decrease | ibuprofen use | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | decline | #9 |
magnesium sulfate | decrease | pain intensity | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #10 |
magnesium sulfate | decrease | disability | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #11 |
magnesium sulfate | decrease | analgesic consumption | patients with unilateral lower limb radiculopathy due to lumbar disc prolapse | - | significantly reduced | #12 |
BACKGROUND: Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections. METHODS: In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups. The control group received dexamethasone (4 mg), lidocaine 2% (40 mg), and saline. The magnesium group received magnesium sulfate (200 mg) with dexamethasone and lidocaine. The dexmedetomidine group received dexmedetomidine (50 mcg), dexamethasone, lidocaine, and saline. Pain intensity was assessed using the visual analog scale at 1 week and 1, 3, and 6 months post-treatment. Secondary outcomes included the Modified Oswestry Disability Index (MODI), analgesic consumption, and procedure-related complications. RESULTS: Both magnesium and dexmedetomidine significantly reduced pain, disability, and analgesic consumption for up to 3 months. By 6 months, the magnesium group demonstrated significant improvement in pain scores and MODI and a decline in ibuprofen use compared to the control and dexmedetomidine groups. CONCLUSIONS: Magnesium significantly reduced pain intensity, disability, and analgesic consumption over a 6-month observation period.