Objective: Caudal epidural steroid injections are used for the symptomatic treatment of radicular lumbosacral pain syndromes, but incorrect injection placement has been recognized as a common problem with the routinely used unguided technique. We aimed to explore the use of sonography to facilitate this procedure.
Methods: In patients with clinically unreliable anatomic landmarks, high-resolution real-time sonography was used to identify those landmarks and to assist in correct needle placement.
Results: Sonography enabled localization of the sacral hiatus landmarks. We found this method particularly useful for guiding needle placement in patients with moderate obesity.
Conclusions: Real-time sonography can facilitate caudal epidural steroid injections.
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http://dx.doi.org/10.7863/jum.2003.22.11.1229 | DOI Listing |
J Clin Med
December 2024
Pain Clinic, Mersin City Education and Research Hospital, Mersin 33343, Turkey.
Recurrent lumbar disc herniation (RLDH) refers to a lumbar disc herniation (LDH) that recurs at the same level, location, and side following surgical repair. This study aimed to evaluate the efficacy of transforaminal epidural steroid injection (TESI) and dorsal root ganglion pulsed radiofrequency (DRG PRF) therapy with and without caudal epidural steroid injection (CESI) for the treatment of lumbar radicular pain (LRP) associated with RLDH. This retrospective cohort study included 57 patients treated for RLDH in a hospital pain clinic between September 2022 and February 2024.
View Article and Find Full Text PDFCureus
December 2024
Anesthesiology and Perioperative Medicine, Medical University of South Carolina, Charleston, USA.
Mymensingh Med J
January 2025
Dr Md Khairul Kabir Khan, Junior Consultant, Department of Anaesthesiology and Intensive Care Unit, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
Different additives have been used to improve the duration and quality of analgesia of the local anaesthetic used in the single-dose caudal block technique, such as opioids, epinephrine, clonidine, neostigmine, etc. Dexmedetomidine is a potent and a highly selective α2-adrenergic agonist having a sympatholytic, sedative, and analgesic effect and has been described as a safe and effective additive in many anaesthetic and analgesic techniques. Another agent is Fentanyl, a lipophilic opioid, is added frequently to local anaesthetics which least likely to cause respiratory depression when given extradurally, because of its high lipid solubility.
View Article and Find Full Text PDFMed J Armed Forces India
December 2024
Senior Consultant (Neurology), NH MMI Superspeciality, Raipur, Chhattisgarh, India.
Background: Endoscopic procedures nowadays are successful, minimally invasive, and safer, with fewer intraoperative and postoperative complications and shorter hospital stays. Kambin's triangle (KT) is the three-dimensional configuration that is used as a transforaminal anatomical corridor for epidural steroid injections and endoscopic surgeries for various lumbar pathologies. This study aims to estimate the dimensions of KT and diameter of the cannula for the transforaminal surgical approaches using KT in the Chhattisgarh population.
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