Retrospective comparison of ultrasound and fluoroscopic image guidance for intercostal steroid injections. Pain Pract 2010;10(4):312-7
Date
03/17/2010Pubmed ID
20230448DOI
10.1111/j.1533-2500.2009.00345.xScopus ID
2-s2.0-78049386504 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
INTRODUCTION: Steroid injection around the intercostal nerves is one of the treatment options for intercostal neuralgia. The technique may be performed blindly, under fluoroscopic guidance (FSG) or with the use of ultrasound guidance (USG). This study is a retrospective comparison of image guidance for intercostal steroid injections.
METHODS: After Institutional Review Board approval, a retrospective review of all patient charts who received intercostal steroid injections from 2005 to 2009 was performed. A total of 39 blocks were performed in that period. Of that 12 were USG blocks and 27 FSG blocks. The preprocedure visual analog scale (VAS) and postprocedure VAS and the duration of pain relief were compared between the 2 techniques. A Mann-Whitney test and Kruskal-Wallis test were performed looking for differences between the techniques.
RESULTS: The median change in the VAS for FSG and USG were -5.000 and -4.000, respectively, and duration of pain relief with a median difference of 2 weeks (95% confidence interval of -4, 7). There were 2 occasions of intravascular spread noticed with the FSG although this should not affect the study result as the needle was repositioned and steroid injected only after contrast dye confirmation.
CONCLUSION: With similar change in VAS scores and duration of pain relief between the 2 guidance methods based on this retrospective study, both image guidance techniques may offer similar pain relief.
Author List
Shankar H, Eastwood DAuthor
Hariharan Shankar MBBS Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
FluoroscopyHumans
Intercostal Nerves
Nerve Block
Neuralgia
Pain Measurement
Retrospective Studies
Statistics, Nonparametric
Steroids
Ultrasonography, Doppler
