| El papel cambiante del ultrasonido en medicina del dolor |
Michael Gofeld
Pain medicine News
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| Eficacia de las inyecciones guiadas con ultrasonido en pacientes con síndrome facetario de la columna lumbar baja |
Efficacy of ultrasonography-guided injections in patients with facet syndrome of the low lumbar spine.
Department of Physical Medicine and Rehabilitation, College of Medicine, Kyung Hee University, Seoul 130-702, Korea.
Ann Rehabil Med. 2012 Feb;36(1):66-71. Epub 2012 Feb 29.
Abstract
OBJECTIVE: To investigate the efficacy of ultrasonography (US)-guided injections in patients with low lumbar facet syndrome, compared with that in patients who received fluoroscopy (FS)-guided injections. METHOD: Fifty-seven subjects with facet syndrome of the lumbar spine of the L4-5 and L5-S1 levels were randomly divided into two groups to receive intraarticular injections into the facet joint. One group received FS-guided facet joint injections and the other group received US-guided facet joint injections. Treatment effectiveness was assessed using a visual analogue scale (VAS), physician's and patient's global assessment (PhyGA, PaGA), and the modified Oswestry Disability Index (MODI). All parameters were evaluated four times: before injections, and at a week, a month, and three months after injections. We also measured, in both groups, how long it took to complete the whole procedure. RESULTS: Each group showed significant improvement from the facet joint injections on the VAS, PhyGA, PaGA, and MODI (p<0.05). However at a week, a month, and three months after injections, no significant differences were observed between the groups with regard to VAS, PhyGA, PaGA, and MODI (p>0.05). Statistically significant differences in procedure time were observed between groups (FS: 248.7±6.5 sec; US: 263.4±5.9 sec; p=0.023). CONCLUSION: US-guided injections in patients with lumbar facet syndrome are as effective as FS-guided injections for pain relief and improving activities of daily living.
http://pdf.medrang.co.kr/paper/pdf/Jkarm/Jkarm036-01-09.pdf
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| Bloqueo de nervio occipital mayor guiado con ultrasonido en pacientes con cefalea occipital y seguimiento a corto plazo |
Ultrasound-guided greater occipital nerve block for patients with occipital headache and short term follow up.
Shim JH, Ko SY, Bang MR, Jeon WJ, Cho SY, Yeom JH, Shin WJ, Kim KH, Shim JC.
Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2011 Jul;61(1):50-4. Epub 2011 Jul 21.
Abstract
BACKGROUND: The greater occipital nerve (GON) block has been frequently used for different types of headache, but performed with rough estimates of anatomic landmarks. Our study presents the values of the anatomic parameters and estimates the effectiveness of the ultrasound-guided GON blockade. METHODS: The GON was detected using ultrasound technique and distance from external occipital protuberance (EOP) to GON, from GON to occipital artery and depth from skin to GON was measured in volunteers. Patients with occipital headache were divided into two groups (ultrasound-guided block: group S, conventional blind block: group B) and GON block was performed. The same parameters were measured on group S and VAS scores were assessed at pretreatment, 1 week and 4 weeks after treatment on both groups. RESULTS: The GON had distance of 23.1 ± 3.4 mm (right) and 20.5 ± 2.8 mm (left) from EOP to GON. Its depth below the skin was 6.8 ± 1.5 mm (right) and 7.0 ± 1.3 mm (left). The distance from GON to occipital artery was 1.5 ± 0.6 mm (right) and 1.2 ± 0.6 mm (left) in volunteers. Initial VAS score of group S and group B patients were 6.4 ± 0.2 and 6.5 ± 0.2. VAS score of 4 weeks after injection were 2.3 ± 0.2 on group S and 3.8 ± 0.3 on group B (P = 0.0003).
CONCLUSIONS: The parameters measured in this study should be useful for GON block and ultrasound-guided blockade is likely to be a more effective technique than blind blockade in occipital headache treatment.
http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-61-50.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155137/pdf/kjae-61-50.pdf
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