Korean J Pain 2024; 37(3): 256-263
Published online July 1, 2024 https://doi.org/10.3344/kjp.24087
Copyright © The Korean Pain Society.
Chan-Sik Kim1 , Hyun-Jung Kwon1
, Sugeun Nam1
, Heeyoon Jang1
, Yeon-Dong Kim2
, Seong-Soo Choi1
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, 2Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, Iksan, Korea
Correspondence to:Seong-Soo Choi
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-1538, Fax: +82-2-3010-6790, E-mail: choiss@amc.seoul.kr
Yeon-Dong Kim
Department of Anesthesiology and Pain Medicine, Wonkwang University School of Medicine, 460, Iksan-daero, Iksan 54538, Korea
Tel: +82-63-859-1562, Fax: +82-63-857-5472, E-mail: kydpain@hanmail.net
Handling Editor: Chee Kean Chen
Received: March 12, 2024; Revised: April 17, 2024; Accepted: April 30, 2024
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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: Cervical Vertebrae, Chronic Pain, Epidural Injection, Fluoroscopy, Neck, Neck Pain, Radiculopathy, Surveys and Questionnaires