Comparing the efficacy of thoracic transforaminal injection of magnesium versus intercostal nerve block with methylprednisolone for chronic post thoracotomy pain syndrome

ABSTRACT

Pain therapy and quality of life [QOL] are very important in patients with post thoracotomy pain syndrome. I evaluated the pain relieving efficacy, and effects on QOL of thoracic transforaminal [i.e. nerve root approach] injection of magnesium diluted with lidocaine versus intercostal nerve block with methylprednisolone and lidocaine in management of chronic post thoracotomy pain syndrome. The study protocol was approved by the local ethics committee. Patients were randomly divided into two groups. Magnesium group; GM, N=20 were treated with magnesium [transforaminal approach], whereas the patients in steroid group; GS, N=20 were treated with methylprednisolone [intercostal nerve block]. The VAS values, codeine consumption, and quality of life= QOL [assessed by Patient satisfaction scale=PSS, and performance status =PS] were evaluated prior to the procedure and at 2 weeks intervals after the procedure for 14 weeks. The demographic data were found to be similar. The comparisons of difference of VAS values were found to be significantly lower in GM than GS in every control till the 12[th] week. GM patients were found to decrease the codeine consumption significantly more than GS till the 14[th] week. GM patients had significant improvement in QOL values especially after 4 weeks [assessed by Patient satisfaction scale=PSS, and performance status =PS]. Comparing the pain relieving efficacy, QOL - effects of the methods, thoracic transforaminal [i.e. nerve root approach] injection of magnesium may be an alternative to traditional intercostal nerve block with steroids in adult patients with post thoracotomy syndrome