Hypericum perforatum to Improve Post-Operative Pain Outcome After Lumbar Mono-segmental Spinal Microdiscectomy (HYPOS) – Preliminary Results of a Randomized Controlled Trial
05 February 2020 (online)
Background: Potentized Hypericum perforatum is known as a remedy for lancinating pain when nerval damage is involved. We aimed at investigating whether additional intake of Hypericum C200 might lead to a significant decrease of perceived pain and conventional pain medication compared to placebo in patients undergoing spinal microdiscectomy.
Methods: Between 2015 and 2018 a randomized controlled trial was conducted in the Department of Neurosurgery at the Community Hospital Herdecke. In-patients undergoing spinal microdiscectomy were randomly selected into homeopathic treatment or placebo, both in addition to usual pain management. 3 globuli of either verum or placebo were administered after surgery every 12 hours for 3–5 days. The primary outcome was pain reduction at these 3–5 post-operative days, measured on a visual analogue scale. Statistical analysis was done by means of a repeated measures model.
Results: A total of 95 patients were included in this preliminary analysis, of which 47 patients (49.5%) received homeopathic treatment. No significant between-group difference was found with respect to patient demographics such as gender (Control: 25 (52.1%) versus Verum: 21 (44.7%) male patients; age (mean: 52.5 ± 14.2 versus 52.2 ± 13.5 years); body mass index (mean: 26.8 ± 4.2 versus 27.9 ± 5.2 years); and duration of surgery (mean: 62.5 ± 20.6 versus 66.4 ± 28.3 min). With respect to pain reduction, there was a similar decrease in pain intensity from 5.6 ± 2.3 (Control) and 5.8 ± 2.6 (Verum) to 3.0 ± 2.6 (Control) and 3.0 ± 2.5 (Verum), with no significant group differences based on complete case analysis (N = 66).
Discussion: This preliminary data analysis showed comparable socio-medical parameters between the two groups. The results however did not confirm any difference in pain reduction between them. Further analyses of the intake of pain medication and the evaluation of sensory and affective pain perception are currently underway.
Keywords: Microdiscectomy, Hypericum perforatum, pain, RCT