The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Current practices of cervical epidural block for cervical radicular pain: a multicenter survey conducted by the Korean Pain Society

  • Chan-Sik Kim (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hyun-Jung Kwon (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sugeun Nam (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Heeyoon Jang (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yeon-Dong Kim (Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine) ;
  • Seong-Soo Choi (Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2024.03.12
  • Accepted : 2024.04.30
  • Published : 2024.07.01
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Abstract

Background: Cervical epidural block (CEB) is an effective intervention for managing cervical radicular pain. This study aimed to investigate the current status of performing CEB in South Korea. Methods: Pain physicians affiliated with the Korean Pain Society were asked to complete anonymous questionnaires regarding CEB between September and October 2022. The questionnaire consisted of 24 questions assessing the current status and methods of CEB in detail. Results: Of the 198 surveys collected, 171 physicians (86.4%) reported performing CEB. Among those, the majority (94.7%) used fluoroscopy during the procedure. The paramedian interlaminar (IL) approach was the most preferred method (50.3%). Respondents performing fluoroscopic-guided IL CEB were categorized into two groups based on clinical experience: those with ≤10 years of experience (≤10-year group, n = 91) and those with >10 years of experience (>10-year group, n = 71). The proportion of physicians obtaining informed consent in the ≤10-year group and >10-year group was 50.5% and 56.3%, respectively. When entering the epidural space during IL CEB, the contralateral oblique view was the second most frequently used in both groups (≤10-year group, 42.9%; >10-year group, 29.6%). In targeting the upper cervical lesions (C3-4), the proportion of respondents who used an IL space higher than C6-7 was 17.6% in the ≤10-year group and 29.5% in the >10-year experience group. Conclusions: This study demonstrated variability in the CEB technique used by pain physicians in South Korea. The findings highlight the need for education on informed consent and techniques to enhance safety.

Keywords

Acknowledgement

The authors thank the 22nd members of the Training & Education Committee of the Korean Pain Society.

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