Background: Intravascular injection is one of complications of caudal block, which can increase failure rate of procedure and cause vascular embolization. Whitacre type needle is reported to be effective to reduce intravascular injection during transforaminal epidural injection. In this study we compared the Whitacre needle and Chiba needle with a respect to the incidence of intravascular injection during caudal block.
Methods: A total of 164 caudal blocks were performed in patients with disc herniation or spinal stenosis on the lumbosacral spine. Patients were randomly allocated to group W (n=82) and group C (n=82). Patients in group W received caudal block with Whitacre needle and those in group C received the intervention with Chiba needle. Intravascular injection was assessed with blood aspiration and angiography during real-time fluoroscopy.
Results: There were no differences in terms of demographic data in two groups. There was no significant difference in the incidence of intravascular injection between group W (19.5%) and C (11%). In addition, there were no complications associated with caudal block in two groups.
Conclusions: In this study, Whitacre needle was not effective to decrease the incidence of intravascular injection, compared to Chiba needle during caudal block
Reference: 1.Fukazawa K, Matsuki Y, Ueno H, Hosokawa T, Hirose M. Risk factors related to accidental intravascular injection during caudal anesthesia. Journal of anesthesia. 2014;28(6):940-943. 2. Hong J, Jung S, Chang H. Whitacre needle reduces the incidence of intravascular uptake in lumbar transforaminal epidural steroid injections. Pain physician. 2015;18:325-331.