Korean J Anesthesiol.  2008 Apr;54(4):427-430. 10.4097/kjae.2008.54.4.427.

The Effective Steroid Dose of Caudal Epidural Injection with Unilateral Epidural Catheter Position in Patients with Symptomatic Herniated Nucleus Purposus

• Shin YH
• Kim TH
• Lee SJ
• Lee CJ
• Sim WS
• Gwak MS
• Kim CS
• Hahm TS
• Kim MH
• Cho HS
• Chung IS
• Lee BD

• KMID: 1763282
• DOI: http://doi.org/10.4097/kjae.2008.54.4.427

Abstract

BACKGROUND: The epidural steroid injection is commonly used in the management of chronic low back pain and radiating pain. We compared the efficacy of 40, 60, and 80 mg of methylprednisolone acetate in patients with lumbar herniated disc disease treated with caudal epidural block.
METHODS
Seventy-two patients with lumbar herniated nucleus purposes on magnetic resonance imaging were included.All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle.After confirming the catheter tip position at the affected nerve root, contrasts were injected until patients felt discomfort in their site of pain.24 patients in each group received 40 mg, 60 mg, 80 mg of methylprednisolone acetate, respectively.We evaluated the improvements by pain relief scale (0-100%) after 2 weeks.
RESULTS
There are no significant differences in the pain improvement between three groups (P = 0.537 ).
CONCLUSIONS
Sixty and 80 mg methylprednisolone acetate injection during caudal epidural block showed no further benefit compared to 40 mg injection.

Keyword

caudal epidural injection; doses of methylprednisolone; herniated nucleus pulposus; low back pain

MeSH Terms

Catheters
Humans
Injections, Epidural
Intervertebral Disc Displacement
Low Back Pain
Magnetic Resonance Imaging
Methylprednisolone
Methylprednisolone