Cervical Transforaminal Epidural Block Using Low-Dose Local Anesthetic: A Prospective, Randomized, Double-Blind Study
- 주제(키워드) Cervical , Transforaminal Epidural Block , Safety , Lidocaine
- 등재 SCIE, SCOPUS
- 발행기관 WILEY-BLACKWELL
- 발행년도 2015
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000114429
- 본문언어 영어
- Published As http://dx.doi.org/10.1111/pme.12582
초록/요약
ObjectivesIntra-arterial injections of local anesthetic during cervical transforaminal epidural block (TFEB) can cause rare but fatal neurologic complications. We hypothesized that using a dose of local anesthetic lower than seizure threshold during cervical TFEB would not be associated with seizure activity in cases of accidental intra-arterial injection. MethodsPatients were randomized to one of two groups: group I received injections of 1mL of 1% lidocaine mixed with dexamethasone 2.5mg (n=15), and group II received 1mL of 0.125% lidocaine mixed with dexamethasone 2.5mg (n=15). When the numeric rating scale (NRS) for pain was greater than 3, cervical TFEBs were performed three times at 2-week intervals. Patients were evaluated up to 3 months. ResultsThirty patients with cervical radicular pain were enrolled in this study. The NRS pain score on the day of procedure and at 2 weeks, 4 weeks, 6 weeks, and 3 months following the initial procedure were similarly significantly reduced in both groups. The total number of procedures performed and the outcomes evaluated according to Odom's criteria at the 3-month follow-up visit were not different between groups. Overall, 73.3% and 80% patients in groups I and II, respectively, rated the degree of their symptom relief as excellent or good. ConclusionCervical TFEB performed using 0.125% lidocaine with dexamethasone achieved similar satisfactory effects as 1% lidocaine with dexamethasone for the treatment of cervical radicular pain. Therefore, the use of low-dose lidocaine with dexamethasone is reasonable for cervical TFEB, as this may reduce the incidence of rare but fatal complications.
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