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ORIGINAL ARTICLE
Year : 2017  |  Volume : 3  |  Issue : 3  |  Page : 119-124

A prospective analysis of ultrasonography-guided caudal epidural steroid in the management of chronic low back pain and radicular leg pain


1 Associate Professor, Department of Anesthesiology, Institute of Anesthesiology and Critical Care, Rajiv Gandhi Government General Hospital Madras Medical College, Chennai, Tamil Nadu, India
2 Senior Assistant Professor and Incharge Consultant, Department of Anesthesiology, Institute of Anesthesiology and Critical Care, Rajiv Gandhi Government General Hospital Madras Medical College; Chronic Pain Management Centre Chennai, Tamil Nadu, India
3 Senior Assistant Professor, Department of Anesthesiology, Institute of Anesthesiology and Critical Care, Rajiv Gandhi Government General Hospital Madras Medical College, Chennai, Tamil Nadu, India

Correspondence Address:
Ashok K Durairaj
Senior Assistant Professor and Incharge Consultant, Department of Anesthesiology Institute of Anesthesiology and Critical Care, Rajiv Gandhi Government General Hospital Madras Medical College; Chronic Pain Management Centre, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.5005/jp-journals-10046-0083

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Introduction: Low back pain and sciatica (LBPS) is a major health and socioeconomic problem in modern India. Inadequate treatment of pain leads to loss of valuable man-hours for the country. Aim: The study aims to validate the effect of ultrasonography (USG)-guided caudal epidural steroid (CES) injection in the management of pain due to LBPS. Materials and methods: This is a noncomparative clinical study in patients with LBPS due to lower lumbar and sacral nerve root involvement. Under USG guidance caudal epidural space was identified; mixture of local anesthetic and methyl prednisolone is injected as bolus dose; and visual analog scale (VAS) score and straight leg raising test (SLRT) were recorded pre- and postprocedure. Patients are followed up to 6 months for assessing the pain relief. Results: The mean VAS score before the procedure is 7.78, postprocedure is 2.95. The SLRT before the procedure is 28.58, and the postprocedure is 71.83. Our study showed statistically significant improvement in pain relief and SLRT. Conclusion: The USG guidance enables us to perform the procedure in real time and helps us to avoid inadvertent vascular deposition of drug. Caudal approach minimizes the possibility of dural puncture. The USG-CES injection is effective in managing the chronic LBPS of lower lumbar and sacral nerve root involvement.


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