Comparison of the efficacy of lidocaine and bupivacaine in lumbar i̇nterlaminar epidural steroid administration

ABSTRACT Comparison of The Efficacy of Lidocaine and Bupivacaine in Lumbar İnterlaminar Epidural Steroid Administration Objectives: Aim of the study is to compare the efficacy of lidocaine and bupivacaine used with corticosteroids in interlaminar epidural steroid injection (ESE) administered to patients with lumbar radiculopathy. Material and Method: 48 patients with lumbar radiculopathy secondary to lumbar disc hernia detected between L3-S1 levels in lumbar MRI were included in the study. Patient files were scanned and straight leg lift test (SLRT) , numerical rating scale (NRS), Oswestry Disability Index (ODI) of patients were recorded before the procedure. Patients whom a total of 8 ml drug mixture consisting of 8 mg dexamethasone +2 cc 0.5% bupivacaine + 4 cc serum physiological (SF) was administered and a total of 8 ml drug mixture consisting of 8 mg dexamethasone + 2 cc 2% lidocaine + 2 cc SF was administered were included study group. Both groups were evaluated for SLR and ODI scores in 1st hour and 1st month, and evaluated for NRS results in 1st hour, 1st month and 3rd month. Results: In the study, there was a significant decrease in the results of DBKT, NRS and ODI results evaluated at the 1st and 3rd months compared to those examined before the intervention in both groups (p <0.001). When the two groups were compared with each other, there was no significant difference in the 1st month (p = 0.864) and 3rd month (p = 0.584) evaluations between SLRT results of two groups. There was no significant difference between the NRS results between the groups in the 1st hour (p = 0,931), 1st month NRS (p = 0,496) and 3rd month (p = 0,428). No significant difference was observed between the 1 month (p = 0,649) and 3 month (p = 0,559) in the ODI results evaluated between the groups. Conclusion: ESE is an effective method in the treatment of radiculopathy due to lumbar disc hernia. Together with dexamethasone, administration of lidocaine or bupivacaine effectively reduces patients' pain and improves the quality of life in interlaminar injections, however, there is no difference in terms of the effectiveness between these two local anesthetic drugs. Keywords: Lumbar disc hernia, radiculopathy, interlaminar epidural steroid injection, lidocaine, bupivacaine