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http://dx.doi.org/10.3344/kjp.2019.32.1.39

Effect of needle type on intravascular injection in transforaminal epidural injection: a meta-analysis  

Kim, Jae Yun (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
Kim, Soo Nyoung (Department of Obstetrics and Gynecology, Konkuk University School of Medicine)
Park, Chulmin (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
Lim, Ho Young (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
Kim, Jae Hun (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
Publication Information
The Korean Journal of Pain / v.32, no.1, 2019 , pp. 39-46 More about this Journal
Abstract
Background: Lumbosacral transforaminal epidural injection (TFEI) is an effective treatment for spinal disease. However, TFEI may have several types of complications, some of which can be attributed to intravascular injection. We reviewed studies to compare the intravascular injection rate among different needle types. Methods: We searched the literature for articles on the intravascular injection rate among different needle types used in TFEI. The search was performed using PubMed, MEDLINE, the Cochrane Library, EMBASE, and Web of Science. Results: A total of six studies comprising 2359 patients were identified. Compared with the Quincke needle, the Whitacre needle reduced the intravascular injection rate (OR = 0.57, 95% CI = [0.44-0.73], P < 0.001). However, compared with the Quincke needle, the Chiba needle did not reduce the intravascular injection rate (OR = 0.80, 95% CI = [0.44-1.45], P = 0.46). In one study, the intravascular injection rate using a blunt-tip needle was lower than that using a sharp needle. In another study, the Whitacre and the blunt-tip needle have similar intravascular injection rates, while, the catheter-extension needle showed a reduced intravascular injection rate. Conclusions: This meta-analysis showed that the Whitacre needle reduced the intravascular injection rate as compared with the Quincke needle, but failed to establish that the Chiba needle can decrease the intravascular injection rate in TFEI. Moreover, the blunt-tip needle can reduce the intravascular injection rate compared with the Quincke needle, and the catheter-extension needle can reduce the intravascular injection rate compared with the Whitacre and the blunt-tip needle.
Keywords
Complication; Epidural anesthesia; Epidural injection; Human; Injection; Meta-analysis; Needle; Spinal diseases; Transforaminal injection;
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Times Cited By KSCI : 5  (Citation Analysis)
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