Korean J Anesthesiol.  2014 Sep;67(3):193-197. 10.4097/kjae.2014.67.3.193.

Comparison of incidence of intravascular injections during transforaminal epidural steroid injection using different needle types

• Hong JH
• Lee YH

• KMID: 1966754
• DOI: http://doi.org/10.4097/kjae.2014.67.3.193

Abstract

BACKGROUND
Infrequent but serious complications of transforaminal epidural steroid injection (TFESI) occur due to inadvertent intravascular injections. A few studies reported that the different needle types can influence on the occurrences of intravascular incidence in TFESI. This study prospectively evaluated whether short-bevel needle can reduce the incidences of intravascular injection of TFESI compared to long-bevel needles.
METHODS
From March 2013 to December 2013, 239 consecutive patients were enrolled and received 249 fluoroscopically guided TFESI using the classic technique. Confirmation of intravascular spread was done initially with real time fluoroscopy and then with digital subtraction angiography method in a same patient. Injection technique for TFESI was the same for both short-bevel and long-bevel needle types.
RESULTS
The incidences of intravascular injections with the long-bevel and short-bevel needles were 15.0% (21/140) and 9.2% (4/140), respectively. More than half of intravascular injections occurred simultaneously with epidural injections (8.0%, 20/249). There were no statistically significant differences between the long-bevel and the short-bevel needles in the rates of intravascular injections (P = 0.17).
CONCLUSIONS
Short-bevel needles did not demonstrate any benefits in reducing the incidence of intravascular injection.

Keyword

Intravascular; Long-bevel; Short-bevel; Transforaminal epidural steroid injection

MeSH Terms

Angiography, Digital Subtraction
Fluoroscopy
Humans
Incidence*
Injections, Epidural
Needles*
Prospective Studies