A STUDY ON TRANSFORAMINAL BLOCK COMPARISON OF TANSELONE AND DEXAMETHASONE
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i6.51395Keywords:
Tanselone, Dexamethasone, Transforaminal epidural steroid injections, Transforaminal blockAbstract
Objectives: To compare the efficacy and safety of Tanselone and Dexamethasone in TFESIs and provide guidance for their use, particularly for new pain specialists and postgraduate students.
Methods: A prospective, randomized controlled trial was conducted, enrolling 100 patients with spinal pain syndromes randomized to receive either Tanselone or Dexamethasone in TFESIs. Pain intensity scores and functional outcomes were assessed at baseline and follow-up intervals (11). Adverse events related to TFESIs were monitored. Statistical analysis was performed to compare outcomes between the two groups.
Results: Tanselone demonstrated superior efficacy in pain relief and functional improvement compared to Dexamethasone, with patients in the Tanselone group experiencing greater reductions in pain intensity scores and improvements in functional outcomes at all follow-up intervals. However, concerns were raised regarding the potential risk of vascular complications associated with Tanselone’s particulate nature. For new pain specialists and postgraduate students, Dexamethasone may be considered a safer alternative to minimize the risk of complications associated with TFESIs (11). A difference which was significant statistically in the Pain intensity score questionnaire (3.73±1.15 in group T, 6.55±0.51 in group Dx) and Oswestry disability index (18.67±7.13 in group T, 35.83±5.10 in group Dx) was found in both but was more in Tanselone group.
Conclusion: By comparing Tanselone and dexamethasone for epidural injection, for the duration of analgesia of pain in lumbar radiculopathy, injection of Tanselone has been found to be more effective than injection of dexamethasone through transforaminal route. Clinicians should weigh the potential benefits of Tanselone’s efficacy against its perceived risks and consider using Dexamethasone, especially for novice practitioners, to minimize the risk of complications and ensure procedural safety in patients with spinal pain syndromes.
Downloads
References
Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Barnhill RC, et al. Evaluation of the relative contributions of various structures in chronic low back pain. Pain Physician. 2001;4(4):308-16. PMID: 16902676
Kennedy DJ, Plastaras C, Casey E, Visco CJ, Rittenberg JD, Conrad B, et al. Comparative effectiveness of lumbar transforaminal epidural steroid injections with particulate versus nonparticulate corticosteroids for lumbar radicular pain due to intervertebral disc herniation: A prospective, randomized, double-blind trial. Pain Med. 2014;15(4):548-55. doi: 10.1111/pme.12325, PMID: 24393129
Fairbank JC, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976). 2000;25(22):2940-52. doi: 10.1097/00007632-200011150- 00017, PMID: 11074683
Benzon HT, Chew TL, McCarthy RJ, Benzon HA, Walega DR. Comparison of the particle sizes of different steroids and the effect of dilution: A review of the relative neurotoxicities of the steroids. Anesthesiology. 2007;106(2):331-8. doi: 10.1097/00000542- 200702000-00022, PMID: 17264728
Manchikanti L, Buenaventura RM, Manchikanti KN, Ruan X, Gupta S, Smith HS, et al. Effectiveness of therapeutic lumbar transforaminal epidural steroid injections in managing lumbar spinal pain. Pain Physician. 2012;15(3):E199-245. PMID: 22622912
Park CH, Lee SH, Kim BI. Comparison of the effectiveness of lumbar transforaminal epidural injection with particulate and nonparticulate corticosteroids in lumbar radiating pain. Pain Med. 2010;11(11):1654- 8. doi: 10.1111/j.1526-4637.2010.00941.x, PMID: 20807343
Kim D, Brown J. Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: A comparison of soluble versus particulate steroids. Clin J Pain. 2011;27(6):518-22. doi: 10.1097/AJP.0b013e31820c53e0, PMID: 21562412
El-Yahchouchi C, Geske JR, Carter RE, Diehn FE, Wald JT, Murthy NS, et al. The noninferiority of the nonparticulate steroid dexamethasone vs the particulate steroids betamethasone and triamcinolone in lumbar transforaminal epidural steroid injections. Pain Med. 2013;14(11):1650-7. doi: 10.1111/pme.12214, PMID: 23899304
Dreyfuss P, Baker R, Bogduk N. Comparative effectiveness of cervical transforaminal injections with particulate and nonparticulate corticosteroid preparations for cervical radicular pain. Pain Med. 2006;7(3):237-42. doi: 10.1111/j.1526-4637.2006.00162.x, PMID: 16712623
Lee JW, Park KW, Chung SK, Yeom JS, Kim KJ, Kim HJ, et al. Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: A comparative study of particulate versus non-particulate steroids. Skeletal Radiol. 2009;38(11):1077-82. doi: 10.1007/s00256-009-0735-5, PMID: 19543892
Shakir A, Ma V, Mehta B. Comparison of pain score reduction using triamcinolone vs. dexamethasone in cervical transforaminal epidural steroid injections. Am J Phys Med Rehabil. 2013;92(9):768-75. doi: 10.1097/PHM.0b013e318282c9f2, PMID: 23370580
Published
How to Cite
Issue
Section
Copyright (c) 2024 Dr. Dileep Dandotiya
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
