ROLE OF PSOAS COMPARTMENT BLOCK IN LOWER BACK PAIN

Abstract

Objective: To compare the clinical and cost effectiveness of Psoas compartment block (PCB) and lumbar epidural over a period of one month in patients suffering from low back pain and radiclupathy.
Methods: This study was conducted at Railway Hospital Rawalpindi over a period of one year from September 2011 to September 2012. Patients of either sex between 30 to 80 years of age, full filling the study diagnostic criteria were selected by non probability purposive sampling. Patients were divided into two treatment groups. One received epidural analgesia and other received psoas compartment block. Relevant history was recorded on proforma. Pre and post treatment pain scores were recorded using VAS and Pakistan Coin Scale (PCS) at day 1, week 1, and at the end of 1 month. In group 1 PCB was administered and in group 2 lumbar epidural was given under strict aseptic measures. In each group dose of depomedrol with lignocaine was injected according to patient’s weight.
Data Analysis and Result: At baseline, average VAS for group-I was 7.209 (SD = 0.640) while in group-II it was 7.310 (SD=0.680). Both the groups had similar VAS at baseline with insignificant difference (p = 0.438).
At day 1, average VAS was significantly lower (p < 0.001) in group-I as compared to group-II i.e. 2.030 ± 0.491 vs. 3.357 ± 1.008. After one week, average VAS for group-I was 2.851 (SD = 0.609) while in group-II it was 3.810 (SD= 1.087). Group-II had significantly higher VAS as compared to group-I (p < 0.001). After one month, average VAS for group-I was 3.060 (SD=0.625) while in group-II it was 4.333 (SD=1.004). VAS of group-II was significantly higher as compared to group-I (p <0.001).
Conclusion: Patients who were given Psoas compartment block were more satisfied as compared to epidural. Their VAS was significantly lower, at day one, but after one week and at the end of one month VAS/PCS was still lower in group I and it was significant. So PCB is easy to apply and it is cost effective as compare to lumbar epidural.