Abstract

OBJECTIVE
The criterion commonly used to determine whether radiofrequency neurotomy may be recommended is based on patient-reported, short-term pain relief following facet block injections. This study evaluated the concordance between two commonly used outcomes for pain relief: the pain numerical rating scale (NRS) and the global perceived improvement (GPI) scale.
DESIGN
This is a retrospective cohort study.
METHODS
Data were obtained from a consecutive cohort of patients through a review of the electronic medical records, with the following inclusion criteria: medial branch facet blocks at either cervical or lumbar spinal regions.
OUTCOME MEASURES
Pain NRS (baseline, postprocedure, and hourly up to 6 hours) and GPI scale are expressed as percent improvement at 6 hours, relative to baseline.
RESULTS
The percent improvement in pain NRS corresponded to 49%, 43%, 34%, 21%, and 36% for baseline vs immediately post-block, 1 hour, 3 hours, 6 hours and average of all postscores, respectively. Average GPI reported at 6 hours was 44%, and differed significantly only to the baseline vs 6 hours percent improvement on the NRS (P < 0.01). Multiple regression analysis indicated that there were no demographic or baseline factors that accounted for the discrepancy between GPI vs NRS.
CONCLUSIONS
Asking patients about their pain relief in retrospect can be misleading. It is possible that patients' report on the GPI is weighed by their total experience of pain reduction and retrospective recall. Therefore, when choosing to address percent improvement on NRS measures, it is important to take into account multiple instances of NRS measures following treatment.

Links

Publisher Full Text

Authors

Theodore BR, Olamikan S, Keith RV, Gofeld M

Institution

Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.

Source

Pain medicine (Malden, Mass.) 13:9 2012 Sep pg 1131-6

MeSH

Analgesics
Chronic Pain
Cohort Studies
Female
Humans
Injections, Spinal
Male
Middle Aged
Nerve Block
Pain Measurement
Retrospective Studies
Self Report
Zygapophyseal Joint

Pub Type(s)

Journal Article
Validation Studies

Language

eng

PubMed ID

22846049