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Ultrasound guided caudal epidural

Liza Maniquis Smigel, Kenneth Dean Reeves, Howard Jeffrey Rosen, David Patrick Rabago
BACKGROUND: Anecdotal evidence suggests that a vertical small-needle injection method enters the caudal epidural space with comparable efficacy to cephalad-directed methods, with less intravascular injection. OBJECTIVES: Assess the success rate of vertical caudal epidural injection using epidurography and the frequency of intravascular injection using a vertical small-needle approach. PATIENTS AND METHODS: Participants had chronic generalized non-surgical low back pain and either gluteal and/or leg pain and were enrolled in a simultaneous clinical trial assessing the analgesic effect of 5% dextrose epidural injection...
June 2016: Anesthesiology and Pain Medicine
Taylan Akkaya, Derya Özkan, Hayri Kertmen, Zeki Şekerci
AIM: The purpose of this study was to compare the results of ultrasound- and fluoroscopy-guided caudal epidural steroid injections in postlaminectomy patients. MATERIAL AND METHODS: Of the 30 postlaminectomy patients who were randomly divided into two groups, Group I (n=15) received ultrasound-guided and Group II (n=15) fluoroscopy-guided caudal epidural local anesthetic and steroid injection, and each patient's time to performed block was recorded. The patients' Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and satisfaction with the therapy during the 3-month follow-up were evaluated...
December 28, 2015: Turkish Neurosurgery
Mark-Friedrich B Hurdle
As the population ages, more patients are developing degenerative changes of the spine and associated pain. Although interventional procedures for axial and radicular spine pain have been available for decades, common imaging modalities have relied on ionizing radiation for guidance. Over the past decade, ultrasound has become increasingly popular to image both peripheral musculoskeletal and axial structures. This article reviews the use of ultrasound in the guidance of spine procedures, including cervical and lumbar facet injections and medial branch blocks, third occipital nerve blocks, thoracic facet and costotransverse joint injections, sacroiliac joint injections, and caudal and interlaminar epidural injections...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Arindam Kumar Hazra, Dipasri Bhattacharya, Sayantan Mukherjee, Santanu Ghosh, Manasij Mitra, Mohanchandra Mandal
BACKGROUND AND AIMS: Caudal epidural steroid administration is an effective treatment for chronic low back pain (LBP). Fluoroscopy guidance is the gold standard for pain procedures. Ultrasound guidance is recently being used in pain clinic procedures. We compared the fluoroscopy guidance and ultrasound guidance for caudal epidural steroid injection with respect to the time needed for correct placement of the needle and clinical effectiveness in patients with chronic LBP. METHODS: Fifty patients with chronic LBP with radiculopathy, not responding to conventional medical management, were randomly allocated to receive injection depot methyl prednisolone (40 mg) through caudal route either using ultrasound guidance (Group U, n = 25) or fluoroscopy guidance (Group F, n = 25)...
June 2016: Indian Journal of Anaesthesia
Atsushi Sawada, Yukitoshi Niiyama, Michiaki Yamakage
BACKGROUND: We investigated the efficacy of ultrasound (US)-guided caudal epidural block for transrectal ultrasound (TRUS)-guided prostate biopsy. METHODS: Sixty adult patients (ASA I or II) were enrolled in this study and randomized into two groups: group S receiving spinal block (n = 30) and group C receiving US-guided caudal epidural block (n = 30). We measured systolic blood pressure (SBP), heart rate (HR), and degrees of sensory and motor blockade. Procedural time for regional anesthesia was recorded...
May 2016: Masui. the Japanese Journal of Anesthesiology
Ki Deok Park, Tai Kon Kim, Woo Yong Lee, JaeKi Ahn, Sung Hoon Koh, Yongbum Park
The aim of the article is to investigate the efficacy of ultrasound (US)-guided Caudal Epidural Steroid Injection (CESI) compared with fluoroscopy (FL)-guided CESI in patients with unilateral lower lumbar radicular pain. This case-controlled, retrospective, comparative study was done at the university hospital. A total of 110 patients treated with US- or FL-guided CESI were administered a mixture of 20 cc (0.5% lidocaine 18.0  mL + dexamethason 10  mg 2  mL). Outcome measurement was assessed by Oswestry Disability Index (ODI), verbal numeric pain scale (VNS) before injections and at 3, 6, and 12 months after the last injections...
December 2015: Medicine (Baltimore)
Dae Hyun Jo
No abstract text is available yet for this article.
October 2015: Korean Journal of Pain
Branislav Mislovic
We report a 2-year-old patient with Opitz-GBBB syndrome scheduled for a posterior sagittal anorectoplasty (PSARP). The ultrasound scan revealed the inferior end of dural sac just below sacrococcygeal membrane, although the patient had previously two successful caudal epidural blocks. Consequently, the epidural catheter was inserted under a real-time ultrasound guidance without dural puncture. Our patient had excellent pain relief without any side effects.
October 2015: Paediatric Anaesthesia
A Ram Doo, Jin Wan Kim, Ji Hye Lee, Young Jin Han, Ji Seon Son
BACKGROUND: Caudal epidural injections have been commonly performed in patients with low back pain and radiculopathy. Although caudal injection has generally been accepted as a safe procedure, serious complications such as inadvertent intravascular injection and dural puncture can occur. The present prospective study was designed to investigate the influence of the depth of the inserted needle on the success rate of caudal epidural blocks. METHODS: A total of 49 adults scheduled to receive caudal epidural injections were randomly divided into 2 groups: Group 1 to receive the caudal injection through a conventional method, i...
April 2015: Korean Journal of Pain
Mahshid Nikooseresht, Masoud Hashemi, Seyed Amir Mohajerani, Farideh Shahandeh, Mahvash Agah
BACKGROUND: The caudal approach to the epidural space has been used for decades to treat low back pain caused by lumbosacral root compression. The use of fluoroscopy during epidural steroid injection is the preferred method for placing the needle more accurately in the sacral hiatus, but it carries the risk of radiation hazard. OBJECTIVES: The aim of the study was to assess the anatomical structure of the sacral hiatus and the feasibility of caudal epidural injections under ultrasound guidance...
May 2014: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
T Gregori, J Viscasillas, L Benigni
Sacrococcygeal epidural anaesthesia allows selective desensitisation of the sacral plexus. Ultrasound is used for guidance in human anaesthesia to facilitate sacrococcygeal epidural injections. The aims of this study were to describe the sonographic appearance of the sacrococcygeal region in dogs and a technique for performing epidural injection at this location under ultrasound guidance. In the preliminary part of the study four cadavers were used to describe the sonoanatomy of the sacrococcygeal space and to develop the ultrasound-guided puncture technique...
July 19, 2014: Veterinary Record
Carl P C Chen, Henry L Lew, Simon F T Tang
No abstract text is available yet for this article.
January 2015: American Journal of Physical Medicine & Rehabilitation
Michael Gofeld, Kacey A Montgomery
SUMMARY Ultrasound-guided procedures are well established and utilized in the regional anesthesia and radiology practice. Conversely, there have been considerable difficulties in implementation of ultrasound in pain medicine. Ultrasonography has to compete with the more established modalities such as fluoroscopy and computed tomography; however, ultrasound has the advantage of radiation safety and point-of care imaging. It also allows direct visualization of tissue planes, blood vessels and nerves. Ultrasound-guided spine interventions are technically feasible and reasonably accurate when validated with conventional radiological modalities...
July 2012: Pain Management
B Messerer, M Platzer, C Justin, M Vittinghoff
Regional anesthesia should be used for children whenever possible and is an essential element of a multimodal pain management. The prerequisites for a safe and effective procedure are detailed knowledge of the anatomical, physiological and pharmacological differences in childhood, the use of age-appropriate equipment and rapid recognition and treatment of possible complications. Extensive experience in pediatric as well as regional anesthesia is essential. The rule for selection of the ideal regional anesthesia procedure for each individual patient is: as central as necessary and as peripheral as possible...
February 2014: Der Schmerz
Yongbum Park, Ji-Hae Lee, Ki Deok Park, Jae Ki Ahn, Jaehyun Park, Haemi Jee
OBJECTIVE: The aim of this study was to compare the short-term effects and advantages of ultrasound-guided caudal epidural steroid injections with fluoroscopy-guided epidural steroid injections for unilateral radicular pain in the lower lumbar spine. DESIGN: A total of 120 patients with unilateral radicular pain were enrolled and randomly assigned to either the fluoroscopy or the ultrasound group. Complication frequencies during the procedures, treatment effects, functional improvement, and adverse events were compared after the procedures...
July 2013: American Journal of Physical Medicine & Rehabilitation
Daniela Marhofer, Peter Marhofer, Stephan C Kettner, Edith Fleischmann, Daniela Prayer, Melanie Schernthaner, Edith Lackner, Harald Willschke, Pascal Schwetz, Markus Zeitlinger
BACKGROUND: This study was designed to examine the spread of local anesthetic (LA) via magnetic resonance imaging after a standardized ultrasound-guided thoracic paravertebral blockade. METHODS: Ten volunteers were enrolled in the study. We performed ultrasound-guided single-shot paravertebral blocks with 20 ml mepivacaine 1% at the thoracic six level at both sides on two consecutive days. After each paravertebral blockade, a magnetic resonance imaging investigation was performed to investigate the three-dimensional spread of the LA...
May 2013: Anesthesiology
Carl P C Chen, Henry L Lew, Wen-Chung Tsai, Yu-Ting Hung, Chih-Chin Hsu
Ultrasound has become a useful adjunct to many procedures performed in rehabilitation medicine. It has the advantages of cost-effectiveness, lack of radiation, and readiness of use and the ability to make dynamic examinations possible compared with other imaging tools. Through dynamic examinations, needles can be guided accurately to the target sites to increase the success rates of aspiration and injection procedures. At present, ultrasound-guided caudal epidural, sacroiliac joint, piriformis muscle, and hip-joint injections are commonly practiced in rehabilitation medicine...
October 2011: American Journal of Physical Medicine & Rehabilitation
Ilana Esquenazi Najman, Thiago Nouer Frederico, Arthur Vitor Rosenti Segurado, Pedro Paulo Kimachi
BACKGROUND AND OBJECTIVES: Caudal epidural anesthesia is the most popular regional anesthesia technique used in children. With advanced age, only the relative difficulty in localizing the sacral hiatus limits its use. However, in adults this technique has been widely used to control chronic pain by adjuvant use of fluoroscopy. Thus, the ability to locate the hiatus and define anatomical variations is the main determinant of the success and safety of caudal epidural anesthesia. In this context, the use of the ultrasound in caudal epidural anesthesia has been increasing...
January 2011: Revista Brasileira de Anestesiologia
Harald Willschke, Anette-Marie Machata, Winfried Rebhandl, Thomas Benkoe, Stephan C Kettner, Lydia Brenner, Peter Marhofer
AIM: To retrospectively describe the performance of ultrasound guided thoracic epidural anaesthesia under sedation for anaesthesia management of open pyloromyotomy. BACKGROUND: Anaesthesia management for hypertrophic pylorus stenosis (HPS) is usually performed under general anaesthesia with tracheal intubation. Only a few publications describe avoidance of tracheal intubation in infants by using spinal or caudal anaesthesia. The present retrospective analysis describes the performance of ultrasound guided thoracic epidural anaesthesia under sedation for anaesthetic management of open pyloromyotomy...
February 2011: Paediatric Anaesthesia
Anne Blanchais, Benoit Le Goff, Pascale Guillot, Jean-Marie Berthelot, Joëlle Glemarec, Yves Maugars
OBJECTIVES: To assess the feasibility and safety of caudal epidural glucocorticoid injections performed with ultrasound guidance. METHODS: We studied 30 patients with low back pain and nerve root pain related to disk herniation or associated with lumbar spinal stenosis. A caudal epidural injection was performed under ultrasound guidance. Prednisolone acetate, 5 ml, was administered with 10 ml of saline and 5 ml of iodinated contrast agent, providing an epidurogram...
October 2010: Joint, Bone, Spine: Revue du Rhumatisme
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