The effect of tramadol and tramadol + gabapentin combination in patients with lumbar disc herniation after epidural steroid injection

Authors: LÜTFİYE PİRBUDAK, HÜLYA ÇİÇEK, MUSTAFA IŞIK, YASEMİN ZER

Abstract: Background/aim: To compare the effects of tramadol-only treatment and tramadol + gabapentin treatment in patients who had received an epidural steroid injection. Materials and methods: Forty patients with hernia disc-originated acute lumbar discogenic pain were evaluated. All patients received a single dose of steroid and local anesthesia mixture epidurally via the lumbar approach. In both groups, Group T (tramadol, n = 20) and Group TG (tramadol + gabapentin, n = 20), the injection dose was adjusted to 4 mL of triamcinolone acetonide and 0.25% bupivacaine mixture. Orally, 75 mg/day tramadol or 75 mg/day tramadol + 900 mg/day gabapentin were added to the treatment. Leukocyte, erythrocyte sedimentation rate, C-reactive protein, and urine serotonin levels were measured prior to and after treatment. The effectiveness of the treatment was evaluated by visual analog scale (VAS), Oswestry Disability Index (ODI), and straight leg elevation test (SLET). Results: Similar improvements in VAS, ODI, and SLET values were observed in both groups in the second week. The inflammation markers were not different after treatment, neither within the groups nor between the groups. Conclusion: This study revealed that tramadol + gabapentin treatment was not superior to tramadol treatment.

Keywords: Lumbar disc herniation, epidural steroid injection, tramadol, gabapentin, lumbar radicular pain

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