Department of Orthopedic Surgery, University of California Los Angeles, UCLA Spine Center.
Department of Rehabilitation Medicine, Weill Cornell Medical Center, New York, New York.
Pain Med. 2019 Apr 1;20(4):779-783. doi: 10.1093/pm/pny322.
To determine if skin wheals reduce procedural pain associated with lumbar medial branch blocks (MBBs) performed with 25-gauge needles.
Prospective comparative observational study.
Outpatient Physical Medicine & Rehabilitation and interventional pain practice within an academic tertiary care center.
Ninety-nine consecutive patients who underwent lumbar MBBs for facet pain were included. Patients who were obese or required larger-diameter needles were excluded.
One to three facet joints were targeted per side, with some patients receiving bilateral procedures. All injections were performed with 25-gauge, 3.5-inch Quincke tip needles under fluoroscopic guidance. A total of 306 needle sticks were recorded. MBBs were performed without skin wheals or any other type of local anesthesia (35 patients, 108 needle sticks), with skin wheals (30 patients, 94 needle sticks), and in mixed groups (34 patients, 47 needle sticks with skin wheals, 57 needle sticks without skin wheals or other type of local anesthesia). Patients rated the pain of each needle placement immediately after the multilevel MBB procedure.
Considering all 306 needle sticks, needles that were placed using skin wheals caused slightly more pain than those placed without skin wheals or any other type of local anesthesia (P = 0.007).
Skin wheals do not reduce and may increase procedural pain associated with lumbar MBBs performed with 25-gauge needles.
确定皮肤丘疹是否会减轻与使用 25 号针进行的腰椎内侧支阻滞（MBB）相关的程序疼痛。
前瞻性比较观察性研究。
门诊物理医学与康复和介入性疼痛实践在学术三级护理中心内进行。
99 例连续接受腰椎 MBB 治疗关节突疼痛的患者入选。肥胖或需要更大直径针头的患者被排除在外。
每侧靶向 1 到 3 个关节突，一些患者接受双侧手术。所有注射均在透视引导下使用 25 号、3.5 英寸 Quincke 尖端针进行。共记录了 306 次针刺。MBB 是在没有皮肤丘疹或任何其他类型局部麻醉的情况下进行的（35 名患者，108 次针刺），有皮肤丘疹（30 名患者，94 次针刺），以及混合组（34 名患者，47 次针刺有皮肤丘疹，57 次针刺没有皮肤丘疹或其他类型局部麻醉）。患者在多节段 MBB 手术后立即对每一次针放置的疼痛进行评分。
考虑到所有 306 次针刺，使用皮肤丘疹放置的针比没有使用皮肤丘疹或任何其他类型局部麻醉放置的针略痛（P=0.007）。
皮肤丘疹不会减轻，甚至可能增加与使用 25 号针进行的腰椎 MBB 相关的程序疼痛。
Zotero 插件