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Risk factors related to accidental intravascular injection during caudal anesthesia

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Abstract

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.

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Conflict of interest

There is no potential conflict of interest to disclose.

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Authors and Affiliations

  1. Pain Management and Palliative Care Unit, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Keita Fukazawa, Hiroshi Ueno & Toyoshi Hosokawa

  2. Departments of Anesthesiology and Reanimatology, Faculty of Medicine Sciences, University of Fukui, 23-3 Eiheijicho, Yoshidagun, Fukui, 910-1193, Japan

    Yuka Matsuki

  3. Department of Anesthesiology, Hyogo College of Medicine, Hyogo, Japan

    Munetaka Hirose

Authors
  1. Keita Fukazawa
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  2. Yuka Matsuki
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  3. Hiroshi Ueno
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  4. Toyoshi Hosokawa
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  5. Munetaka Hirose
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Corresponding author

Correspondence to Yuka Matsuki.

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Fukazawa, K., Matsuki, Y., Ueno, H. et al. Risk factors related to accidental intravascular injection during caudal anesthesia. J Anesth 28, 940–943 (2014). https://doi.org/10.1007/s00540-014-1840-8

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  • DOI: https://doi.org/10.1007/s00540-014-1840-8

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