Abstract

MURADA, P. et al. Errores en el procedimiento del bloqueo epidural. Rev. argent. radiol. [online]. 2015, vol.79, n.3, pp.139-144. ISSN 1852-9992.

Objectives: To present a number of cases in which pitfalls may occur during the performance of epidural block, so they may be prevented and corrected during the procedure. Materials and methods: A retrospective analysis was performed on 118 patients who suffered lumbar pain, radicular pain or both and who underwent CT-guided minimally invasive antiinflammatory analgesic treatment by selective injection of drugs in the epidural space, between January 2013 and April 2014. In all cases a spinal needle 21G was used. Injected deposit steroid (betamethasone 3mg) and anesthetic (lidocaine 1ml 2%+0.5ml bupivacaine 0.5%) or only steroid in those cases where perforation of the dura was suspected. The cases with pitfalls during the procedure were selected. Results: Five patients (4.23%) had technical complications during epidural block. The complications were observed after an inadequate position of the needle tip (perforation of the dura and insufficiency access to the epidural space), which were due to the direct aspiration of cerebrospinal fluid (LCR) or by the placing of that was used as a tracer prior to the drug injection. The errors produced were detected and corrected without any problems. Conclusion: Epidural block is a practice frequently used in the management of chronic lumbar pain. Pitfalls and complications of the procedure are rare. It is important that the physician has the experience and knowledge for handling them and their subsequent correction.

Keywords : Epidural block; Pitfalls; Experience; Radiculopathy; Spinal.