Department of Anesthesiology and Pain Medicine, School of Medicine, Yeungnam University Medical Center.
Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University.
Medicine (Baltimore). 2020 Dec 18;99(51):e23665. doi: 10.1097/MD.0000000000023665.
Caudal epidural injection (CEI) is effective for lumbar spinal pain. However, accidental intravascular injection reduces therapeutic efficacy of CEI and leads to fatal complications such as hematoma, and neurologic deficit. Whitacre needle has been reported to be effective for reducing intravascular injection during transforaminal epidural injection, compared with Quincke needle. The bevel of Chiba needle is shorter than that of Quincke needle. In this study we compared Whitacre needle and Chiba needle on incidence of intravascular injection during CEI.This was a single-blind, randomized clinical consort study. After institutional Review Board approval, a total of 164 patients underwent CEI were randomly allocated to one of 2 group (Whitacre needle or Chiba needle group). Intravascular injection was assessed with real-time fluoroscopy. In addition, total procedure time was measured. Data were compared between groups, and P < .05 was consideredstatistically significant.There were no differences between groups in terms of patient demographic and clinical characteristics. There was no significant difference on incidence of intravascular injection between Whitacre and Chiba needle group (11% vs 19.5%, P = .192). However, the procedure time is significantly longer in the Whitacre than Chiba needle group (172.8 ± 53.8 sec vs 147.1 ± 61.1 sec, P = .005).Based on current study, our results indicated that Whitacre needle was not effective to decrease the incidence of intravascular injection during CEI, compared to Chiba needle.
硬膜外腔尾侧注射（CEI）对治疗腰椎脊柱疼痛有效。然而，意外的血管内注射会降低 CEI 的治疗效果，并导致致命的并发症，如血肿和神经功能缺损。与 Quincke 针相比，Whitacre 针已被报道可有效减少经椎间孔硬膜外注射中的血管内注射。Chiba 针的斜面比 Quincke 针短。在本研究中，我们比较了 Whitacre 针和 Chiba 针在 CEI 中血管内注射发生率方面的差异。这是一项单盲、随机临床对照研究。在机构审查委员会批准后，共有 164 例接受 CEI 的患者被随机分配到两组（Whitacre 针或 Chiba 针组）。通过实时荧光透视评估血管内注射。此外，还测量了总手术时间。比较了两组之间的数据，P 值<.05 被认为具有统计学意义。两组患者的人口统计学和临床特征无差异。Whitacre 针和 Chiba 针组的血管内注射发生率无显著差异（11%比 19.5%，P=0.192）。然而，Whitacre 针组的手术时间明显长于 Chiba 针组（172.8±53.8 秒比 147.1±61.1 秒，P=0.005）。根据目前的研究，我们的结果表明，与 Chiba 针相比，Whitacre 针在降低 CEI 期间血管内注射的发生率方面没有效果。
