Ultrasound-Assisted Versus Fluoroscopic-Guided Lumbar Sympathetic Ganglion Block: A Prospective and Randomized Study. Anesth Analg 2018 Apr;126(4):1362-1368
Date
12/01/2017Pubmed ID
29189275DOI
10.1213/ANE.0000000000002640Scopus ID
2-s2.0-85034262067 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
BACKGROUND: Fluoroscopy (FL)-guided lumbar sympathetic ganglion block (LSGB) is widely performed to diagnose and manage various diseases associated with sympathetically maintained pain. Recently, numerous ultrasound (US)-assisted procedures in pain medicine have been attempted, showing an advantage of low radiation exposure. This randomized, prospective trial compared the procedural outcomes and complications between FL-guided and US-assisted LSGBs.
METHODS: Fifty LSGBs were randomly divided into 2 groups: FL-guided (FL group) or US-assisted (US group) LSGB group. Both groups received FL-guided or US-assisted LSGB with 10 mL of 0.25% levobupivacaine. The primary end point was the total procedure time. Secondary outcomes were success rate, imaging time, onset time (based on temperature rise), dosage of radiation exposure, other procedure-related outcomes, and complications.
RESULTS: Total procedure time and success rate were not statistically different between the 2 groups, whereas imaging time of the US group was longer than that of the FL group (P = .012). The onset time was faster in the US group (P = .019), and bone touching during the procedure was less frequent in the US group (P = .001). Moreover, radiation exposure was significantly lower in the US group than in the FL group (P < .001). No serious complications were reported in all patients.
CONCLUSIONS: US-assisted LSGB appears to be a feasible method with the added benefit of lower radiation exposure. In our study, we did not find an advantage of US-assisted LSGB over FL-guided LSGB in terms of performance time.
Author List
Ryu JH, Lee CS, Kim YC, Lee SC, Shankar H, Moon JYAuthor
Hariharan Shankar MD Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAutonomic Nerve Block
Complex Regional Pain Syndromes
Female
Fluoroscopy
Ganglia, Sympathetic
Humans
Lumbar Vertebrae
Male
Middle Aged
Neuralgia
Pain Measurement
Prospective Studies
Radiation Dosage
Radiation Exposure
Radiography, Interventional
Seoul
Time Factors
Treatment Outcome
Ultrasonography, Interventional
