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Pain Management 2019 & Internal Medicine 2019 International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X Page 63
JOINT EVENT
7th Edition of International Conference on
Pain Management
8th Edition of International Conference on
Internal Medicine &
Patient Care
&
March 25-26, 2019
Rome, Italy
Int J Anesth Pain Med 2019, Volume 5
DOI: 10.21767/2471-982X-C1-006
Comparison of intravascular injection rate between blunt
and sharp needles during cervical transforaminal epidural
block
Saeyoung Kim
Kyungpook National University, South Korea
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 due to their dull needle tip.
Objective: To investigate whether there is a difference
between blunt and sharp needles in intravascular
injection rates during CTEB.
Methods: After Institutional Review Board approval, 108
participants undergoing CTEB for treatment of radicular
pain resulting from spinal stenosis and herniated nucleus
pulposus were randomly assigned to one of two 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 real-time
fluoroscopy.
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 ± 12.4s vs., 56.67 ±
8.3s, 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.