Abstract
We have reported the effectiveness of intrathecal lidocaine and steroids in the five elderly patients (aged 74 to 83) who had refractory low back and/or lower limb pain originated from multiple operations on their backs. They were treated with epidural block three times and simultaneously daily orally administered for treatment with 150 mg of mexiletine, 15 mg of baclofen (these dosage were divided by 3), and 25 mg of amitriptyline (before sleep). However, neither the low back pain nor the lower limb pain decreased. Intrathecal block by 1 ml of 0.5% lidocaine and 3.3 mg of dexamethasone sodium phosphate was continued 7 times at 2-weeks intervals. The patients were assessed their pain intensity with pain scores used by a visual analogue scale (VAS, mm) 14 weeks later. Pain scores at before treatment were 74 mm in case one; 62 mm in case two; 81 mm in case three; 78 mm in case four; and 100 mm in case five. Pain scores after treatment were 33 mm, 60 mm, 5 mm, 29 mm and 25 mm, respectively. Although the pain score decreased in 4 cases, it did not decrease in case 2 because this patient complained of widespread low back and lower limb pain. An intrathecal block with local anesthetics containing glucocorticoid might be useful for the pain management in backs that have undergone multiply operations.
