Jin Young Lee1, Sung Hyun Lee2, Woo Seog Sim1, Duk Kyung Kim1, Sang Hoon Lee3, Hyo Min Yun3, Hue Jung Park4. 1. Department of Anesthesiology and Pain Medicine, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea. 2. Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea. 3. Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea. 4. Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, South Korea. huejungi@naver.com.
Abstract
OBJECTIVE: The aim of this study was to analyze the influence of epidural catheters on the incidence of intravascular injection and to identify possible predictors of intravascular injection in patients undergoing a caudal block using fluoroscopy. METHODS: A total of 154 patients scheduled to receive a caudal block were randomized into group N (those without epidural catheter) or group C (those with epidural catheter). Demographic and clinical data were recorded and analyzed. RESULTS: The incidence of intravascular injection was 15.6% in group N, 6.5% in group C, and 11.0% overall, without statistical differences between the two groups (P = 0.105). Univariate analysis revealed that blood at hub (P = 0.047) and positive aspiration test (P = 0.045) were more frequently observed in group N than in group C. Quality of analgesia was significantly higher in group C than in group N (P = 0.029). Multivariate analysis identified older age (P = 0.024), blood at hub (P = 0.003), and positive aspiration test (P = 0.001) as predictors of intravascular injection. CONCLUSIONS: In this study, while the incidence of intravascular injection during caudal blocks was less frequent with epidural catheter use, it was not statistically significant. However, a caudal block using an epidural catheter provided a lower incidence of blood at hub, fewer positive aspiration tests, and superiority in pain improvement.
RCT Entities:
OBJECTIVE: The aim of this study was to analyze the influence of epidural catheters on the incidence of intravascular injection and to identify possible predictors of intravascular injection in patients undergoing a caudal block using fluoroscopy. METHODS: A total of 154 patients scheduled to receive a caudal block were randomized into group N (those without epidural catheter) or group C (those with epidural catheter). Demographic and clinical data were recorded and analyzed. RESULTS: The incidence of intravascular injection was 15.6% in group N, 6.5% in group C, and 11.0% overall, without statistical differences between the two groups (P = 0.105). Univariate analysis revealed that blood at hub (P = 0.047) and positive aspiration test (P = 0.045) were more frequently observed in group N than in group C. Quality of analgesia was significantly higher in group C than in group N (P = 0.029). Multivariate analysis identified older age (P = 0.024), blood at hub (P = 0.003), and positive aspiration test (P = 0.001) as predictors of intravascular injection. CONCLUSIONS: In this study, while the incidence of intravascular injection during caudal blocks was less frequent with epidural catheter use, it was not statistically significant. However, a caudal block using an epidural catheter provided a lower incidence of blood at hub, fewer positive aspiration tests, and superiority in pain improvement.
Authors: Matthew Smuck; Brian J Fuller; Anthony Chiodo; Benoy Benny; Balaji Singaracharlu; Henry Tong; Suehun Ho Journal: Spine (Phila Pa 1976) Date: 2008-04-01 Impact factor: 3.468
Authors: D L Renfrew; T E Moore; M H Kathol; G Y el-Khoury; J H Lemke; C W Walker Journal: AJNR Am J Neuroradiol Date: 1991 Sep-Oct Impact factor: 3.825
Authors: Laxmaiah Manchikanti; Kim A Cash; Vidyasagar Pampati; Carla D McManus; Kim S Damron Journal: Pain Physician Date: 2004-01 Impact factor: 4.965
Authors: Woo Seog Sim; Hue Jung Park; Ji Hye Kwon; Min Seok Oh; Hyun Joo Jung; Min Kyoung Cho; Jin Young Lee Journal: Medicine (Baltimore) Date: 2019-05 Impact factor: 1.817