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10 Spontaneus reduction of analgesics after interventional technique for lumbar chronic pain, as a marker of it’s effectiveness
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  1. I Fuertes-Arenal,
  2. P Lejarraga,
  3. R Vela-Pascual,
  4. L Velasco,
  5. S Garcia-Hernandez,
  6. F Higuero-Cantonero,
  7. F De la Gala Garcia,
  8. A Alonso Chico,
  9. S Zapatero García,
  10. J Blanco Aceituno,
  11. E Lopez Perez and
  12. J Aguilar Godoy
  1. Hospital General Universitario Gregorio Marañon, Madrid, Spain

Abstract

Background and Aims Interventional techniques for chronic lumbar Pain Release (ITPR) are widely performed but there’s little evidence about how to assess its success. The aim of this study is to assess if quitting or reducing analgesics one month after an ITPR is useful as an objective measure of its success.

Methods 251 adult patients were included in this observational prospective study.Pain intensity (numeric rating score) and disability (Oswestry scale) were assessed via telephone before ITPR, and 1 month later. In addition, analgesics cessation or dose reduction was asked.

As success we considered major improvement when a 3 point in NRS and a 40% in Oswestry reduction was reported. Moderate improvement was considered to be a 2 point reduction and a 20% respectively. If either criteria were met, no improvement was assessed.

We calculated sensitivity, specifity, and predictive values of quitting or reducing medication, for each success criteria.

Results Number/percentage of patients meeting each criteria are shown in table no.1

Cease of medication showed a 95% and 97% specifity for major and moderate improvement. Sensibility was 48% and 27%. PPV was 64% and 80%. NPV was 92% and 76% respectively.

Dose reduction showed an 82% and 85% specifity for major and minor improvement, and 56% and 43% sensibility. PPV was 32% and 55%. NPV was 92 and 78%.

Abstract 10 Table 1

Conclusions 48,5% of those who had major improvement with an ITPR quitted spontaneously at least one analgesic of its daily medication. Also, it showed an 92,3% NPV and 64% PPV. Prevalence of major improvement was 13%.

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