The dilemma of interventional pain trials: thinking beyond the box

“I want a parachute that is based on good research”1Interventional pain medicine is rapidly growing, yet it is lacking in robust evidence. The problem is not limited to a particular geography, rather it is ubiquitous across the globe, with uniform dearth of good-quality data. The increasing numbers of intervention procedures speak for themselves; as per 2014 –15 UK Hospital Episodes Statistics (HES) data, there were 82 188 therapeutic epidurals, 13 796 facet joint denervations, and 83 308 ‘other procedures’ around the spine.2 The narrative is similar in the USA, with a ∼11% annual increase in select Medicare service beneficiaries, whereas facet joint and sacroiliac joint interventions increased by 313% in the last decade.3 Understandably, this presents a challenge to commissioners, funding organizations, and prescribers alike. Considering the competing interests of funding authorities and health policy-makers to execute cost-saving measures, whilst ensuring sustainability of the delivery of the health-care system, it is more imperative than before that we address this issue, so as to allow a congenial conclusion to this rather needless rigmarole.
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research