Comparative study between epidural methylprednisolone and indomethacin in chronic low back pain patients using P300

Thirty patients were included in this study and divided into two equal groups: Group I received 80 mg methylprednisolone [MTP] epidurally and group II received 2 mg lyophilized, preservative-free indomethacin [INM] epidurally. Another dose of the drug was given after two weeks. The values of absolute peak latencies and amplitudes of P300 were recorded before [baseline] and after two weeks of the first injection as well as after two weeks of the second injection in both groups. The intensity of pain was also recorded using a 10-cm visual analog scale [VAS]. The study concluded that INM administered epidurally is a good alternative to MTP whenever corticosteroids are contraindicated in chronic low back pain patients

Effect of clonidine on plasma lidocaine concentrations during continuous thoracic epidural anaesthesia in chidren

This study was performed to assess the concentrations of plasma lidocaine and its major metabolite [monoethylglycinexylidide [MEGX]] in children receiving continuous thoracic epidural anesthesia after oral clonidine premedication. Ten pediatric patients, aged 1-9 years, were randomly allocated to the control or clonidine 4 mug/kg group [n = 5 each]. Anesthesia was induced and maintained with sevoflurane in oxygen and air [F1O2 40%] epidural puncture and tubing was carefully performed at the thoracic 11-12 intervertebral space. An initial dose of 1% lidocaine [5 mg/kg] was injected through a catheter in the epidural space, followed by 2.5 mg/kg/hr. The plasma concentrations of lidocaine and MEGX were measured at 15 minutes, 30 minutes and every 60 minutes for 4 hours after the initiation of continuous epidural injection. The concentrations of lidocaine and MEGX were measured using high-pressure liquid chromatography with ultraviolet detection. The hemodynamic variables were similar between the control and clonidine groups during anesthesia. The clonidine group showed significantly smaller lidocaine concentrations and the concentration of MEGX tended to be smaller in the plasma of the clonidine group for the initial four hours after the initiation of epidural infusion. In conclusion, oral clonidine pre-anesthetic medication at a dose of 4 mug/kg decreases plasma lidocaine concentration in children