Epidural @entity1338 XXXX for intractable @entity5 . The Epidural @entity1338 Study Group.

@entity1 @entity390 @entity5 @entity1337 @entity158 @entity1286 @entity1338 @entity551 @entity9
Although the vast majority of @entity1 with @entity5 receive effective @entity1337 from standard therapy, a few @entity1 , particularly those with @entity9 , continue to experience severe @entity158 despite large doses of systemic or intraspinal opioids. Animal studies suggest intraspinal alpha 2-adrenergic agonists may be effective in such cases. Eighty-five @entity1 with severe @entity5 despite large doses of opioids or with therapy-limiting side effects from opioids were randomized to receive, in a double-blind manner, 30 micrograms/h epidural @entity1338 or placebo for 14 days, together with rescue epidural @entity1286 . @entity158 was assessed by visual analog score (VAS), McGill @entity158 Questionnaire, and daily epidural @entity1286 use. Success was defined as a decrease in either @entity1286 use of VAS @entity158 , with the alternative variable either decreasing or remaining constant. Blood pressure, heart rate, and degree of @entity390 and sedation were monitored. Successful @entity1337 was more common with epidural @entity1338 (45%) than with placebo (21%). This was particularly prominent in those with @entity9 (56% vs. 5%). @entity158 scores were lower at the end of the treatment period in @entity1 with @entity9 treated with @entity1338 rather than placebo, whereas @entity1286 use was unaffected. @entity1338 , but not placebo, decreased blood pressure and heart rate. @entity551 was considered a serious complication in 2 @entity1 receiving @entity1338 and in 1 @entity1 receiving placebo. This study confirms the findings from previous animal studies which showed the effective, potent analgesic properties of intraspinal alpha 2-adrenergic agonists and suggests that epidural @entity1338 may provide effective relief for intractable @entity5 , particular of the neuropathic type.
