Quick Search:

uzh logo
Browse by:
bullet
bullet
bullet
bullet

Zurich Open Repository and Archive

Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-35458

Brötz, D; Maschke, E; Burkard, S; Engel, C; Mänz, C; Ernemann, U; Wick, W; Weller, M (2010). Is there a role for benzodiazepines in the management of lumbar disc prolapse with acute sciatica? Pain, 149(3):470-475.

[img]
Preview
Accepted Version
PDF
1MB

View at publisher

Abstract

Patients with acute lumbar disc prolapse with sciatica who are not considered candidates for surgery are usually treated with physiotherapy and non-steroidal anti-inflammatory agents. Moreover, the treatment with benzodiazepines is common practice in the absence of class I or II level of evidence. Here we assessed the role of benzodiazepines in the conservative management of acute lumbar disc prolapse. Using a placebo-controlled, double-blinded design, 60 patients were randomized to receive placebo or diazepam in addition to mechanical physiotherapy and analgesics for the first 7 days of conservative treatment of clinically and radiologically confirmed lumbar disc prolapse. The primary objective was to evaluate if physiotherapy plus analgesics, but without benzodiazepines, is equivalent to the same therapy plus benzodiazepines. The primary endpoint was centralization of referred pain at day 7. Twenty-six female and 34 male patients were enrolled. The median age was 42 years (range 22-68 years). Analysis of the primary endpoint demonstrated equivalence between placebo and diazepam (median 60% vs. 50% reduction of distance of referred pain at day 7) within the predefined equivalence tolerance of 20% at a significance level of p<0.05. Regarding the secondary endpoints, the median duration of the stay in hospital was shorter in the placebo arm (8 vs. 10 days, p=0.008), and the probability of pain reduction on a visual analog scale by more than 50% was twice as high in placebo patients (p<0.0015). Benzodiazepines should not be used routinely in patients treated with mechanical physiotherapy for lumbar disc prolapse.

Citations

7 citations in Web of Science®
12 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

181 downloads since deposited on 17 Aug 2010
18 downloads since 12 months

Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
DDC:610 Medicine & health
Language:English
Date:June 2010
Deposited On:17 Aug 2010 11:49
Last Modified:27 Nov 2013 19:27
Publisher:Elsevier
ISSN:0304-3959
Publisher DOI:10.1016/j.pain.2010.02.015
PubMed ID:20362397

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page