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KMID : 0948920130120020080
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Clinical Pain
2013 Volume.12 No. 2 p.80 ~ p.86
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Effect of Caudal Epidural Injection ac-cording to Needle Length
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Kim Dong-Hwan
Kim Hee-Sang
Yoo Seung-Don
Yun Dong-Hwan
Chon Jin-Mann
Lee Seung-Ah
Kang Jin-Kyu
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Abstract
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Objective: To analyze the effect and adverse effect of cau-dal epidural injection according to needle length difference.
Method: Patients were randomly allocated into 2 groups. Group A was injected by 22-gauge long spinal needle (9 cm), and Group B was injected by 25-gauge short needle (3.5 cm). Pain or disability experienced during daily life were assessed before injection using the Visual Analogue Score (VAS), the Oswestry Disability Index (ODI) and the Roland-Morris Disability Questionnaire (RDQ). Also, imme-diately after injection, the pain experienced during needle insertion was assessed by VAS. After 2 weeks, patients were reassessed using the same outcome measures.
Results: Fifty-eight patients underwent caudal epidural in-jection, and group A was 30 patients, group B was 28 patients. Both groups demonstrated significant improvement after injection in all outcome measures. The degree of im-provement in the VAS, ODI, RDQ were not significantly dif-ferent between two groups (p＞0.05). This result suggest that the needle length difference does not affect the pain relief effect of caudal epidural injection, and in Group B, the degree of pain during needle insertion was significantly low (p=0.031) and any adverse effect related with dural irri-tation, which were found in 5 patients of Group A, was not reported.
Conclusion: Caudal epidural injection by 25-gauge 3.5 cm short needle are as effective as 22-gauge 9 cm long needle for pain relief in patients with low back pain or radicular leg pain. Caudal epidural injection by 25-gauge 3.5 cm short needle is less painful and safe methods of ensuring that injections are administered into epidural space.
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KEYWORD
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Low back pain, Caudal epidural injection, Needle length, Adverse effect
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