Journal of Korean Society of Geriatric Neurosurgery 2007;3(1):46-49.
Published online June 30, 2007.
The Role of Nerve Blocks in Patients Older Than 75 years
Je-On Park , Sang Dae Kim , Dong Jun Lim, Tae Hyung Cho , Jung Yul Park

Department of neurosurgery, Korea University Ansan Hospital, Korea University School of Medicine, Ansan, Korea

75세 이상의 고령환자에서 신경차단술의 역할

박제언ㆍ김상대ㆍ임동준ㆍ조태형ㆍ박정율

고려대학교 의과대학 안산병원 신경외과학교실

Abstract
Objective
s: The goal of this study was to establish the role of nerve blocks for various pain syndromes, by demonstrating the benefits and usefulness, in patients older than 75 years.
Methods
A retrospective analysis was based on the data obtained from 136 patients with various spinal diseases, 75 years or more, who received nerve blocks for painful conditions between Mar. 2002 and Dec. 2006. Underlying disorders for the painful conditions were spinal stenosis, degenerative disc disease, compression fracture, and facet syndrome. Medial branch block, dorsal root ganglion block, gray ramus communicans nerve block were included among various treatment options. All nerve blocks were performed after careful medical history taking and obtaining an informed consent. All blocks were done in operating room with C-arm guidance and all patients were observed more than 30 minutes before discharge from hospital. They were performed in a weekly basis with observation of any side effects or complications. The outcome of pain procedures was analyzed by using Visual Analog Scale (VAS) at baseline and 6 months following 2~3 nerve blocks. The number of nerve blocks was depended upon the degrees and duration of pain relief and it was averaged 2.3 in numbers.
Results
All patients tolerated procedures well. Significant pain relief seen at 6 months was noted in 109 patients (80.1%) with initial VAS score 7.46, and post-block VAS score 2.48. None of these patients required other surgical procedures during follow-up period. There were no major procedure related complications except few patients with dizziness and transient numbness and/or weakness that were fully recovered after 1~2 hours (2.9%/injection).
Conclusions
The results of this study, although representing only 6 months follow-up evaluation, the various nerve block procedures are considered as safe and effective therapeutic options for even very old patients who show unsatisfactory results to conservative managements including medications, physical therapy or other types of treatments.
Key Words: Nerve blockㆍOld ageㆍSpinal disorderㆍBack painㆍPrognosis


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