Abstract

MUNTANE SANCHEZ, A.; FONTES CARAME, D.; MAYORAL ROJALS, V.  and  AJA RODRIGUEZ, L.. Technical aspects of CT guided caudal infiltration. Rev. Soc. Esp. Dolor [online]. 2010, vol.17, n.8, pp.372-375. ISSN 1134-8046.

Introduction: Caudal epidural infiltration is currently one of the most used regional analgesia techniques for control of chronic low pack pain. Our primary objective in this presentation is to highlight a new technique for performing this intervention which is simpler and less aggressive for the patient than that classically used. Material and methods: This new technique has been used on 13 patients (2 males and 11 females) between 33 and 84 years. All patients had chronic lumbar pain. A General Electric Light Speed 16 CT scanner, a 22G lumbar puncture needle and appropriate sterile measures, were used to perform the technique. The CT scanner is a tool that makes it much easier to visualise the sacrococcygeal ligament. After the needle is introduced, and checked using CT, into the caudal spinal canal, the bevel is turned in the cranial direction in order that the medication administered comes out of the needle orifice towards the neural canal. Discussion: The most common technique for performing caudal epidural infiltration is usually done in the prone position with the head turned to one side using an X-ray arch. Using this technique we show that the puncture is less aggressive, quicker and with fewer possibilities of complications. The risk of perforating the dural sac is practically non-existent. There is also less risk of producing haematomas or infections, due to there being much less manipulation of the needle and only involves a direct puncture. In the 100% of cases on which our technique has been performed, the diffusion of the administered medication has been made in the cranial direction, which has been verified using contrast added to the pharmacological mixture.

Keywords : Tomography computed; Analgesia; Epidural; Caudal.

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