scholarly journals Correlation Between Intravascular Injection Rate, Pain Intensity, and Degree of Cervical Neural Foraminal Stenosis During a Cervical Transforaminal Epidural Block

2021 ◽  
Vol Volume 14 ◽  
pp. 3017-3023
Author(s):  
Jiseob Kim ◽  
Kilhyun Kim ◽  
MinKyu Lee ◽  
Saeyoung Kim
Keyword(s):  
Pain Intensity ◽  
Injection Rate ◽  
Epidural Block ◽  
Foraminal Stenosis ◽  
Intravascular Injection

scholarly journals Comparison of Intravascular Injection Rate Between Blunt and Sharp Needles During Cervical Transforaminal Epidural Block

2019 ◽  
Vol 3 (22;3) ◽  
pp. 265-270
Author(s):  
Saeyoung Kim
Keyword(s):  
Contrast Medium ◽  
Tertiary Hospital ◽  
Radicular Pain ◽  
Injection Rate ◽  
Epidural Block ◽  
Procedure Time ◽  
Intravascular Injection ◽  
Needle Position ◽  
Blunt Needle ◽  
Sharp Needle

Background: Cervical transforaminal epidural block (CTEB) is a useful option in the diagnosis and treatment of cervical radicular pain. However, inadvertent intravascular injection can lead to severe neurologic complications. Blunt needles are considered to displace instead of penetrate vessels because of their dull needle tip. Objectives: To investigate whether there is a difference between blunt and sharp needles in intravascular injection rates during CTEB. Study Design: Prospective, randomized, clinical trial. Setting: A tertiary hospital in South Korea. Methods: After institutional review board approval, 108 patients undergoing CTEB for treatment of radicular pain resulting from spinal stenosis and herniated nucleus pulposus were randomly assigned to one of 2 needle groups (blunt needle or sharp needle). The needle position was confirmed using biplanar fluoroscopy, and 2 mL of nonionic contrast medium was injected to detect intravascular injection. Intravascular injection was defined as the contrast medium spreading out through the vascular channel during injection under realtime fluoroscopy. This study was registered in ClinicalTrials.gov. Results: The intravascular injection rate was not significantly different between the blunt needle and sharp needle groups (35.2% vs. 33.3%, P > 0.05). The procedure time was longer in the blunt needle group than in the sharp needle group (101.00 ± 12.4 seconds vs. 56.67 ± 8.3 seconds, P < 0.001). Limitations: This was a single-center study. Additionally, the physicians could not be blinded to the type of needle used. Conclusions: In the present study, use of a blunt needle did not reduce the rate of intravascular injection during CTEB compared to use of a sharp needle. In addition, procedure time significantly increased with blunt needle use compared to sharp needle use. Key words: Analgesia, bleeding, blunt needle, cervical spine, clinical trials, complications, intravascular injection, radiculopathy, sharp needle, transforaminal epidural block

Poster 313 A Retrodiskal Approach of Lumbar Transforaminal Epidural Block in a Case of Severe Foraminal Stenosis

PM&R ◽  
2011 ◽  
Vol 3 ◽  
pp. S281-S281
Author(s):  
Chang J. Moon ◽  
Jaeki Ahn ◽  
Sung H. Kang ◽  
Chul Kim
Keyword(s):  
Epidural Block ◽  
Foraminal Stenosis

scholarly journals Motor Neuron Diseases Accompanying Spinal Stenosis: A Case Study

2016 ◽  
Vol 3;19 (3;3) ◽  
pp. E455-E458
Author(s):  
Yun Suk Choi
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Magnetic Resonance Images ◽  
Epidural Block ◽  
Lower Limbs ◽  
Leg Pain ◽  
Foraminal Stenosis ◽  
Motor Neuron Diseases ◽  
Disc Protrusion ◽  
Epidural Steroid Injections

A 75-year-old man, who was healthy, visited the hospital because of shooting pain and numbness in both lower limbs (right > left). The patient had an L4/5 moderate right foraminal stenosis and right subarticular disc protrusion and received a lumbar epidural block. The patient experienced severe weakness in the right lower limb after 2 days. Lumbar and cervical magnetic resonance images were taken and electromyography and a nerve conduction study were performed to arrive at the diagnosis of a motor neuron disease. The patient expired 4 months later with respiratory failure due to motor neuron disease. This case suggests that any abnormal neurological symptoms that occur after an epidural block should be examined thoroughly via testing and consultations to identify the cause of the symptoms. Key words: Leg pain, epidural steroid injections, motor neuron disease Pain Physician 2016; 19:E455-E458

Comparison of Touhy and Quincke needles on intravascular injection rate in lumbar transforaminal epidural block: a randomized prospective trial

2021 ◽  
pp. rapm-2021-102504
Author(s):  
Hyojung Soh ◽  
Yujin Jeong ◽  
Eung Don Kim
Keyword(s):  
Steroid Injection ◽  
Prospective Trial ◽  
Injection Rate ◽  
Epidural Steroid Injection ◽  
Tuohy Needle ◽  
Spinal Cord Infarction ◽  
Procedure Time ◽  
Intravascular Injection ◽  
Transforaminal Epidural Steroid Injection ◽  
Epidural Steroid

BackgroundTransforaminal epidural steroid injection is widely used in clinical practice to effectively deliver injectate into the ventral epidural space. Complications associated with intravascular injection such as spinal cord infarction and paraplegia can occur during transforaminal epidural steroid injection. To improve the safety of the procedure, avoidance of intravascular injection is crucial, for which appropriate needle selection is important. The primary aim of this study was to compare intravascular injection rates during transforaminal epidural steroid injection between commonly used Quincke and Tuohy needles.MethodTwo hundred and four transforaminal epidural steroid injection cases were randomly assigned to one of two needle groups (22-gage Quincke needle or 22-gage Tuohy needle). Intravascular injection was evaluated using digital subtraction angiography. Spread of contrast medium to the ventral and medial epidural spaces was evaluated. Procedure time was compared between the two needle types.ResultsThe overall incidence of intravascular injection was 7.8%. The rate of intravascular injection was significantly lower in the Tuohy needle group than the Quincke needle group (2.9% vs 12.7%, p=0.009). The ventral and medial epidural spread rates of the Tuohy needle group were 92.2% and 95.1%, respectively, significantly higher than those of the Quincke needle group. The procedure time was shorter in the Tuohy needle group than in the Quincke needle group (97.4 (19.3) seconds vs 117.8 (31.9) s; mean difference −20.40 (95% CI −34.35 to −6.45), p=0.005).ConclusionsIn conclusion, Tuohy needles had a lower intravascular injection rate and higher medial and ventral epidural spreading rates than Quincke needles.Trial registration numberKCT0002095.

Permeability of Endometrial Blood Vessels to Exogenous Horse Radish Peroxidase in Mice. Electron Microscope Study

1973 ◽  
Vol 31 ◽  
pp. 562-563
Author(s):  
M.C. Castillo-Jessen ◽  
A. González-Angulo
Keyword(s):  
Electron Microscopy ◽  
Blood Vessels ◽  
Electron Microscope Study ◽  
Ultrastructural Level ◽  
Low Molecular Weight ◽  
Horse Radish Peroxidase ◽  
Intravascular Injection ◽  
Normal Morphology ◽  
Functional Implications ◽  
Low Molecular Weight Proteins

Information regarding the normal morphology of uterine blood vessels at ultrastructural level in mammals is scarce Electron microscopy studies dealing with endometrial vasculature despite the functional implications due to hormone priming are not available. Light microscopy observations with combined injection of dyes and microradiography along with histochemical studies does not enable us to know the detailed fine structure of the possible various types of blood vessels in this tissue. The present work has been designed to characterize the blood vessels of endometrium of mice as well as the behavior of the endothelium to injection of low molecular weight proteins during the normal estrous cycle in this animal. One hundred and forty female albino mice were sacrificed after intravascular injection of horse radish peroxidase (HRP) at 30 seconds, 5, 15, 30 and 60 minutes.

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