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Korean Journal of Anesthesiology 2008;54(4):427-430.
DOI: https://doi.org/10.4097/kjae.2008.54.4.427   
The Effective Steroid Dose of Caudal Epidural Injection with Unilateral Epidural Catheter Position in Patients with Symptomatic Herniated Nucleus Purposus.
Young Hee Shin, Tae Hyeong Kim, Seok Jin Lee, Chul Joong Lee, Woo Seok Sim, Mi Sook Gwak, Chung Soo Kim, Tae Soo Hahm, Myung Hee Kim, Hyun Sung Cho, Ik Soo Chung, Byung Dal Lee
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. bluecar.kim@samsung.com
Abstract
BACKGROUND
The epidural steroid injection is commonly used in the management of chronic low back pain and radiating pain. We compared the efficacy of 40, 60, and 80 mg of methylprednisolone acetate in patients with lumbar herniated disc disease treated with caudal epidural block.
METHODS
Seventy-two patients with lumbar herniated nucleus purposes on magnetic resonance imaging were included.All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle.After confirming the catheter tip position at the affected nerve root, contrasts were injected until patients felt discomfort in their site of pain.24 patients in each group received 40 mg, 60 mg, 80 mg of methylprednisolone acetate, respectively.We evaluated the improvements by pain relief scale (0-100%) after 2 weeks.
RESULTS
There are no significant differences in the pain improvement between three groups (P = 0.537 ).
CONCLUSIONS
Sixty and 80 mg methylprednisolone acetate injection during caudal epidural block showed no further benefit compared to 40 mg injection.
Key Words: caudal epidural injection; doses of methylprednisolone; herniated nucleus pulposus; low back pain


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