A prospective double blind study of cervical nerve infiltration with isotonic saline and local anaesthetic

Purpose of the study: Aim of this investigation was the examination of the therapeutic effect of cervical nerve infiltration with mepivacaine in compa rison to local applications of isotonic sodium chlorid solution in a prospe ctive randomised double blind study. Methods: 57 patients with cervicocephalgia or cervicobrachialgia were injec ted daily with mepivacaine (n=28) or physiological sodium chlorid solution (n=29). The success was judged through the blinded patients and blinded the rapists first after three days of treatment. If no improvement occurred a s ingle injection of mepivacaine and triamcinolonacetonid was given. This inj ection could be repeated if required. At the end of the inpatient treatment , after a mean of 14 days, the patients assessed the treatment according to a scale of 1-4 (painfree - no improvement). Results: The average therapeutic effect, in the subjective appraisal of 1-4 by the patients,was 2.15 in the mepivacaine-group and 2.54 in the sodium c hlorid - group. In the mepivacaine-group no pain (note 1) was achieved two times and 21 times a clear improvement (note 2), while in the sodium chlori d - group 18 times a clear improvement was achieved and never freedom of pa in (p<0,038). In the mepivacaine-group twice a steroidinjection was require d,while in the sodium chlorid - group this was necessary in 16 cases (p<0,0 1). Conclusion: Cervical injections with mepivacaine improve the subjective pai n perception in cervicocephalgia and cervicobrachialgia significantly bette r than isotonic sodium chlorid - solution in short term results and can the refore be prefered. After an inpatient treatment good and excellent subject ive results could be achieved in a high percentage.