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Sind subkutane CO2-insufflationen als zusatzbehandlung zu einer physikalisch-rehabilitativen standardbehandlung bei patienten mit unspezifischen nacken -- oder ruckenschmerzen analgetisch wirksam? (Are subcutaneous CO2 insufflations analgesically effective as add-on treatment to standard physical rehabilitative treatment in patients with non-specific neck or low back pain? A pragmatic, open, randomized controlled trial) [German]
Brockow T, Dillner A, Franke A, Resch KL
Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2002 Feb;12(1):15-24
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: At present, data on the analgesic effectiveness of subcutaneous carbon dioxide insufflations (SCI) in musculoskeletal conditions only exist from uncontrolled clinical trials. OBJECTIVE: The trial aimed to evaluate the analgesic effectiveness of SCI as an add-on treatment to standard physical rehabilitative treatment (SPT) in persons with non-specific neck or low back pain. SETTING: Inpatient, orthopaedic rehabilitation hospital. DESIGN: Pragmatic, open, randomized controlled trial. PATIENTS: 140 consecutive subjects with non-specific neck and/or low back pain (mean age 65 +/- 7.3 years) were included. INTERVENTIONS: Patients received either SCI (10 treatments in 12 days) and SPT or SPT alone (Add-on Design). MAIN OUTCOME MEASURES: Affective pain perception (42-point scale), sensory pain perception (30-point scale), pain intensity (100 mm visual analogue scale). RESULTS: Between-groups differences were -2.2 (95% CI -5.2 to +0.9) affective pain perception, -1.2 (-3.0 to +0.7) sensory pain perception, and -6.5 (-14 to +1.0) pain intensity in favour of SCI. CONCLUSION: SCI do not seem to be a worthwhile adjunct in a multitreatment setting. Possibly, SPT have masked a greater benefit of SCI. Further trials should be run in a monotherapeutic setting.

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