Table of Contents Author Guidelines Submit a Manuscript
Pain Research and Management
Volume 2016, Article ID 4158291, 7 pages
http://dx.doi.org/10.1155/2016/4158291
Clinical Study

Needle Tip Position and Bevel Direction Have No Effect in the Fluoroscopic Epidural Spreading Pattern in Caudal Epidural Injections: A Randomized Trial

1Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Neungdong-ro 120-1, Kwangjin-gu, Seoul 05030, Republic of Korea
2Department of Anesthesiology and Pain Medicine, Wondang OK Pain Clinic, 783 Hoguk-ro, Deogyang-gu, Goyang-si, Gyeonggi-do 10461, Republic of Korea

Received 8 September 2015; Accepted 26 November 2015

Copyright © 2016 Won Kyoung Kwon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. L. Manchikanti, V. Singh, V. Pampati, F. J. E. Falco, and J. A. Hirsch, “Comparison of the efficacy of caudal, interlaminar, and transforaminal epidural injections in managing lumbar disc herniation: is one method superior to the other?” Korean Journal of Pain, vol. 28, no. 1, pp. 11–21, 2015. View at Publisher · View at Google Scholar · View at Scopus
  2. S. P. Cohen, M. C. Bicket, D. Jamison, I. Wilkinson, and J. P. Rathmell, “Epidural steroids: a comprehensive, evidence-based review,” Regional Anesthesia and Pain Medicine, vol. 38, no. 3, pp. 175–200, 2013. View at Publisher · View at Google Scholar · View at Scopus
  3. J. G. Leem, “Epidural steroid injection: a need for a new clinical practice guideline,” Korean Journal of Pain, vol. 27, no. 3, pp. 197–199, 2014. View at Publisher · View at Google Scholar · View at Scopus
  4. L. Manchikanti, P. S. Staats, D. E. Nampiaparampil, and J. A. Hirsch, “What is the role of epidural injections in the treatment of lumbar discogenic pain: a systematic review of comparative analysis with fusion,” Korean Journal of Pain, vol. 28, no. 2, pp. 75–87, 2015. View at Publisher · View at Google Scholar · View at Scopus
  5. A. T. Parr, L. Manchikanti, H. Hameed et al., “Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature,” Pain Physician, vol. 15, no. 3, pp. E159–E198, 2012. View at Google Scholar · View at Scopus
  6. J. H. Lee, J. H. An, and S.-H. Lee, “Comparison of the effectiveness of interlaminar and bilateral transforaminal epidural steroid injections in treatment of patients with lumbosacral disc herniation and spinal stenosis,” Clinical Journal of Pain, vol. 25, no. 3, pp. 206–210, 2009. View at Publisher · View at Google Scholar · View at Scopus
  7. R. Gupta, S. Singh, S. Kaur, K. Singh, and K. Aujla, “Correlation between epidurographic contrast flow patterns and clinical effectiveness in chronic lumbar discogenic radicular pain treated with epidural steroid injections via different approaches,” Korean Journal of Pain, vol. 27, no. 4, pp. 353–359, 2014. View at Publisher · View at Google Scholar · View at Scopus
  8. W. E. Ackerman III and M. Ahmad, “The efficacy of lumbar epidural steroid injections in patients with lumbar disc herniations,” Anesthesia and Analgesia, vol. 104, no. 5, pp. 1217–1222, 2007. View at Publisher · View at Google Scholar · View at Scopus
  9. J. H. Lee, D. M. Yoon, T. D. Kwon, and K. B. Yoon, “An evaluation of contrast medium spread on caudal epidurography with the needle positioned toward the affected side in patients with unilateral lumbosacral radiculopathy,” Skeletal Radiology, vol. 41, no. 12, pp. 1613–1618, 2012. View at Publisher · View at Google Scholar · View at Scopus
  10. A. Ali, S. A. Khan, A. Aurangzeb et al., “Lumbar disc herniation in patients with chronic backache,” Journal of Ayub Medical College, Abbottabad, vol. 25, no. 3-4, pp. 68–70, 2013. View at Google Scholar · View at Scopus
  11. Y. Ishimoto, N. Yoshimura, S. Muraki et al., “Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: the Wakayama Spine Study,” Osteoarthritis and Cartilage, vol. 21, no. 6, pp. 783–788, 2013. View at Publisher · View at Google Scholar · View at Scopus
  12. P. H. Rosenberg, L. Saramies, and A. Alila, “Lumbar epidural anaesthesia with bupivacaine in old patients: effect of speed and direction of injection,” Acta Anaesthesiologica Scandinavica, vol. 25, no. 3, pp. 270–274, 1981. View at Publisher · View at Google Scholar · View at Scopus
  13. M. Yokoyama, M. Hanazaki, H. Fujii et al., “Correlation between the distribution of contrast medium and the extent of blockade during epidural anesthesia,” Anesthesiology, vol. 100, no. 6, pp. 1504–1510, 2004. View at Publisher · View at Google Scholar · View at Scopus
  14. C.-C. Liu, J. Spielberger, W.-Y. Chou, S.-W. Chau, P.-H. Liu, and P.-H. Tan, “Evaluation of the effects of caudal or cephalic epidural catheterization on the characteristics of lumbar epidural anesthesia,” Acta Anaesthesiologica Taiwanica, vol. 43, no. 2, pp. 79–83, 2005. View at Google Scholar · View at Scopus
  15. W. Y. Park, K. C. Poon, M. D. Massengale, and T. E. Macnamara, “Direction of the needle bevel and epidural anesthetic spread,” Anesthesiology, vol. 57, no. 4, pp. 327–328, 1982. View at Publisher · View at Google Scholar · View at Scopus
  16. W. A. Visser, R. A. Lee, and M. J. M. Gielen, “Factors affecting the distribution of neural blockade by local anesthetics in epidural anesthesia and a comparison of lumbar versus thoracic epidural anesthesia,” Anesthesia and Analgesia, vol. 107, no. 2, pp. 708–721, 2008. View at Publisher · View at Google Scholar · View at Scopus
  17. B. Borghi, V. Agnoletti, A. Ricci, H. Van Oven, N. Montone, and A. Casati, “A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block,” Anesthesia and Analgesia, vol. 98, no. 5, pp. 1473–1478, 2004. View at Google Scholar · View at Scopus
  18. M. Dauri, T. Sidiropoulou, E. Fabbi, P. P. Mariani, and A. F. Sabato, “Intentional lateral epidural catheter placement for anterior cruciate ligament reconstruction,” Acta Anaesthesiologica Scandinavica, vol. 49, no. 5, pp. 671–676, 2005. View at Publisher · View at Google Scholar · View at Scopus
  19. J. H. Kim, H. J. Jung, F. S. Nahm, and P. B. Lee, “Does improvement in epidurography following percutaneous epidural neuroplasty correspond to patient outcome?” Pain Practice, vol. 15, no. 5, pp. 407–413, 2015. View at Publisher · View at Google Scholar · View at Scopus
  20. C. H. Oh, G. Y. Ji, P. G. Cho et al., “The catheter tip position and effects of percutaneous epidural neuroplasty in patients with lumbar disc disease during 6-months of follow-up,” Pain Physician, vol. 17, no. 5, pp. E599–E608, 2014. View at Google Scholar · View at Scopus
  21. F. Lee, D. E. Jamison, R. W. Hurley, and S. P. Cohen, “Epidural lysis of adhesions,” Korean Journal of Pain, vol. 27, no. 1, pp. 3–15, 2014. View at Publisher · View at Google Scholar · View at Scopus
  22. J. Devulder, L. Bogaert, F. Castille, A. Moerman, and G. Rolly, “Relevance of epidurography and epidural adhesiolysis in chronic failed back surgery patients,” Clinical Journal of Pain, vol. 11, no. 2, pp. 147–150, 1995. View at Publisher · View at Google Scholar · View at Scopus
  23. K.-M. Kim, H.-S. Kim, K.-H. Choi, and W.-S. Ahn, “Cephalic spreading levels after volumetric caudal epidural injections in chronic low back pain,” Journal of Korean Medical Science, vol. 16, no. 2, pp. 193–197, 2001. View at Publisher · View at Google Scholar · View at Scopus
  24. D. L. Rabinovitch, A. Peliowski, and A. D. Furlan, “Influence of lumbar epidural injection volume on pain relief for radicular leg pain and/or low back pain,” Spine Journal, vol. 9, no. 6, pp. 509–517, 2009. View at Publisher · View at Google Scholar · View at Scopus
  25. D. T. Murphy, E. C. Kavanagh, A. Poynton, V. O. Chan, M. R. Moynagh, and S. Eustace, “MR epidurography: distribution of injectate at caudal epidural injection,” Skeletal Radiology, vol. 44, no. 4, pp. 565–571, 2015. View at Publisher · View at Google Scholar · View at Scopus
  26. M. Cleary, C. Keating, and A. R. Poynton, “The flow patterns of caudal epidural in upper lumbar spinal pathology,” European Spine Journal, vol. 20, no. 5, pp. 804–807, 2011. View at Publisher · View at Google Scholar · View at Scopus
  27. H. Higuchi, Y. Adachi, and T. Kazama, “Factors affecting the spread and duration of epidural anesthesia with ropivacaine,” Anesthesiology, vol. 101, no. 2, pp. 451–460, 2004. View at Publisher · View at Google Scholar · View at Scopus
  28. Q. H. Hogan, R. Prost, A. Kulier, M. L. Taylor, S. Liu, and L. Mark, “Magnetic resonance imaging of cerebrospinal fluid volume and the influence of body habitus and abdominal pressure,” Anesthesiology, vol. 84, no. 6, pp. 1341–1349, 1996. View at Publisher · View at Google Scholar · View at Scopus