Difference of spreading levels of solution in the cervical epidural injection

BACKGROUNDS: Although cervical epidural block could be a useful therapeutic treatment of head, neck, and upper extremities pain, there is no consensus regarding the volume of injection needed for it in the pain management. We studied the spreading vertebral segments after cervical epidural injection with 2.5 ml, 5 ml and 10 ml of the contrast media and local anesthetic. METHODS: Total 137 patients suffering from head, neck, and upper extremity pain were selected. Cervical epidural blocks were performed consecutively with 2.5 ml (n=51) and 5 ml (n=42) and 10 ml (n=42) of 0.4% mepivacaine and iopamidol 222 mg I/ml at C7-T1. Both anteroposterior (AP) and lateral radiographs were obtained under a fluoroscopy and evaluated upper and lower epidural spreading vertebral levels of contrast media. RESULTS: We performed cervical epidural blocks without complications. Rostral spreading vertebral segments of contrast media in group 1, 2 and 3 were 6.0 ± 1.3, 5.5 ± 1.3, and 4.0 ± 2.1, respectively. Caudal spreading segments in each group were 6.9 ± 4.3, 5.2 ± 3.6, and 4.3 ± 2.3, respectively. Total vertebral spreading segments of contrast media were significantly difference between each group. Vertebral spreading segments of contrast media into C2 segment and caudal spreading below the T6 segment were significant differences between group 3 and two other groups. Rostral spreading to C1 segment was significantly difference between group 1 and two other groups. CONCLUSION: Total vertebral spreading segments of contrast media were significantly different between each group. 5 ml and 10 ml of epidural injection volumes could be enough to spread entire cervical spine. 5 ml of epidural injection volume might be the most efficient volume for the cervical epidural block than 2.5 ml or 10 ml of volume in terms of enough cervical spreading for covering lesions as well as preventing unnecessary spreading to C1 segment.

Author dc:creator

• 노, 현주

Contributors dc:contributor

• 한, 경림
• 대학원 의학과
• 200624541

• 경부경막외강차단
• 조영제
• 경막외강내 약물확산

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000009219
000000009219

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1817