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성인에서 미추 경막외 차단 시 이상적인 바늘 천자 각도

Other Titles
 The Optimal Angle of Needle Insertion for Caudal Block in Adults 
 이호동  ;  윤덕미  ;  박은영  ;  이형석  ;  윤경봉  ;  김원옥  ;  고신옥 
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.54(3) : 295-299, 2008 
Journal Title
Issue Date
caudal block ; chronic low back pain ; optimal angle ; ultrasound
BACKGROUND: This study was conducted to investigate the optimal angle of needle insertion during caudal epidural injection in chronic low back pain patients using ultrasound imaging. METHODS: One hundred eight patients (40 male and 68 female patients) with low back pain and sciatica were studied.Soft tissue ultrasonography was performed to identify the sacral hiatus. The optimal angle of the needle to the skin was measured with an imaginary line drawn parallel to the sacral base using a protractor on a longitudinal plane. A 22-gauge caudal epidural needle was inserted and was guided by ultrasound to the sacral hiatus and into the caudal epidural space. RESULTS: The mean +/- SD for the intercornual distance, depth of the caudal space and the thickness of the sacrococcygeal membrane were 19.0 +/- 3.2 mm, 3.6 +/- 0.9 mm and 1.8 +/- 0.8 mm, respectively. The optimal angle showed a significant correlation with the depth of the caudal space and the thickness of the sacrococcygeal membrane. The mean +/- SD for the optimal angle of the needle insertion was 23.5 +/- 6.9 degrees. CONCLUSIONS: We conclude that the needle should be inserted at an angle of approximately 23.5 degrees to the skin in order to avoid injury to the periosteum and an inadvertent intra-osseous injection.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Kim, Won Oak(김원옥)
Park, Eun Young(박은영)
Yoon, Kyoung Bong(윤경봉) ORCID logo https://orcid.org/0000-0002-4167-1375
Yoon, Duck Mi(윤덕미)
Rhee, Ho Dong(이호동)
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