Clin Orthop Surg.  2017 Jun;9(2):190-192. 10.4055/cios.2017.9.2.190.

The Use of Contrast in Caudal Epidural Injections under Image Intensifier Guidance: Is It Necessary?

• Naidoo K
• Alazzawi S
• Montgomery A

• KMID: 2412287
• DOI: http://doi.org/10.4055/cios.2017.9.2.190

Abstract

BACKGROUND
We investigated the value of using contrast as an additional aid to confirm the accuracy of needle placement for caudal epidural injections under intraoperative image intensifier guidance.
METHODS
A total of 252 consecutive patients were included in this study. Their mean age was 46.7 years (range, 32 to 76 years). There were 133 males (53%) and 119 females (47%) over a 12-month period.
RESULTS
Of the 252 consecutive procedures, the contrast enhanced image intensifier confirmed accurate needle placement on first attempt in 252 cases (100%). Needle resiting following the infiltration of contrast was required in 0 case.
CONCLUSIONS
The results from this study demonstrate that a surgeon beyond the learning curve can accurately place caudal epidural injections using image intensification only, without the use of contrast.

Keyword

Caudal anesthesia; Epidural injections; Spine; Fluoroscopy

MeSH Terms

Adult
Aged
Anesthesia, Caudal/*methods/statistics & numerical data
Female
Fluoroscopy/*methods/statistics & numerical data
Humans
Injections, Epidural/*methods/statistics & numerical data
Male
Middle Aged
Needles
Prospective Studies
Radiographic Image Enhancement/*methods
Spine/*diagnostic imaging

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