Risk factors related to accidental intravascular injection during caudal anesthesia
Risk factors related to accidental intravascular injection during caudal anesthesia
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DOI：
10.1007/s00540-014-1840-8
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发表时间：
2014-12-01
影响因子：
2.8
通讯作者：
Hirose, Munetaka
中科院分区：
文献类型：
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作者：
Fukazawa, Keita;Matsuki, Yuka;Hirose, Munetaka
最近，超声引导下的尾麻用于腰椎手术后的疼痛控制。尽管众所周知，血管内注射通常发生在脊柱的尾部，而且在超声检查下注射时无法检测到这一点，但血管内注射的危险因素尚未得到评估。为了评估预测尾部麻醉期间意外血管内注射的风险指数，我们回顾了慢性下腰痛患者接受骶管造影术的医院记录。多因素Logistic回归分析显示，腰椎神经根症状(OR，2.511，95%CI，1.097~5.748)和症状持续时间(OR，1.006，95%CI，1.002~1.010)是骶管造影术中意外血管内注射的独立危险因素。这项研究表明，腰椎慢性神经根性症状的患者在尾麻期间意外血管内注射药物的发生率更高。
Recently, ultrasound-guided caudal anesthesia has been performed for postoperative pain management after lumbar spine surgery. Although it is well known that intravascular injection often occurs in the caudal part of the spine, and that this cannot be detected at the time of injection under ultrasound screening, the risk factors for intravascular injection have not been evaluated. To assess the risk index for prediction of accidental intravascular injection during caudal anesthesia, we retrospectively examined the hospital records of patients suffering from chronic low back pain who underwent sacral epidurography. Multivariate logistic regression analysis demonstrated that radicular symptoms of the lumbar spine (OR, 2.511, 95 % CI, 1.097-5.748) and duration of symptoms (OR, 1.006, 95 % CI, 1.002-1.010) were significant and independent risk factors for accidental intravascular injection during sacral epidurography. This study suggests that the incidence of accidental intravascular drug injection during caudal anesthesia would be higher in patients with chronic radicular symptoms of the lumbar spine.