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Comparison of Whitacre and Chiba type needles on the incidence of intravascular injection in caudal epidural injections
Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea1, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea2, Department of Anesthesiology and Pain Medicine, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea3
Background
Intravascular injection is one of the complications of caudal epidural injection, which can cause embolization and local anesthetics systemic toxicity as well as failure of procedure. Whitacre type needle has been reported reducing intravascular injection during transforaminal epidural injection. Therefore, we assessed the effect of Whitacre type needle on incidence of intravascular injection during caudal epidural injection.
Methods
A total of 164 caudal epidural injections were performed in patients with disc herniation or spinal stenosis on lumbosacral region. Patients were randomly allocated to Group W (n=82) and Group C (n=82). Patients in Group W received caudal epidural injection using Whitacre type needle and those in groups C received the procedure using Chiba type needle. Intravascular injection was assessed with blood aspiration and angiography during real-time fluoroscopy.
Results
There were no differences between groups in terms of patient characteristics. There was no significant difference on incidence of intravascular injection between Group W and Groups C (19.5% vs 11.0%, P=0.128). In addition, there were no complications associated with procedure in both group.
Conclusions
In this study, Whitacre type needle do not reduce the incidence of intravascular injection, compared to Chiba type needle.
References
1.Ann Conn, Ricardo M.Buenaventura, Sukdeb Datta, Salahadin Abdi, Sudhir Diwan. Systematic Review of Caudal Epidural Injections in the Management of Chronic Low Back Pain. Pain Physician 2009; 12:109-135
2.Jaehyuck Shin, Yong Chul Kim, Sang Chul Lee, Jae Hun Kim. A Comparison of Quincke and Whitacre Needles with Respect to Risk of Intravascular Uptake in S1 Transforaminal Epidural Steroid Injections: A Randomized Trial of 1376 Cases: prospective, randomized study. Anesth Analg 2013;117:1241
Intravascular injection is one of the complications of caudal epidural injection, which can cause embolization and local anesthetics systemic toxicity as well as failure of procedure. Whitacre type needle has been reported reducing intravascular injection during transforaminal epidural injection. Therefore, we assessed the effect of Whitacre type needle on incidence of intravascular injection during caudal epidural injection.
Methods
A total of 164 caudal epidural injections were performed in patients with disc herniation or spinal stenosis on lumbosacral region. Patients were randomly allocated to Group W (n=82) and Group C (n=82). Patients in Group W received caudal epidural injection using Whitacre type needle and those in groups C received the procedure using Chiba type needle. Intravascular injection was assessed with blood aspiration and angiography during real-time fluoroscopy.
Results
There were no differences between groups in terms of patient characteristics. There was no significant difference on incidence of intravascular injection between Group W and Groups C (19.5% vs 11.0%, P=0.128). In addition, there were no complications associated with procedure in both group.
Conclusions
In this study, Whitacre type needle do not reduce the incidence of intravascular injection, compared to Chiba type needle.
References
1.Ann Conn, Ricardo M.Buenaventura, Sukdeb Datta, Salahadin Abdi, Sudhir Diwan. Systematic Review of Caudal Epidural Injections in the Management of Chronic Low Back Pain. Pain Physician 2009; 12:109-135
2.Jaehyuck Shin, Yong Chul Kim, Sang Chul Lee, Jae Hun Kim. A Comparison of Quincke and Whitacre Needles with Respect to Risk of Intravascular Uptake in S1 Transforaminal Epidural Steroid Injections: A Randomized Trial of 1376 Cases: prospective, randomized study. Anesth Analg 2013;117:1241
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