Related Experiment Video

Updated: Sep 21, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
03:14

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

Published on: January 31, 2025

620

Comparison of Intravascular Uptake Using Touhy or Quincke Needle During Lumbar Medial Branch Block

Ji Hee Hong1, Ki Beom Park2, Sung Won Jung3

  • 1Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, Korea.

Pain Physician
|June 2, 2022
PubMed
Abstract

Insights

This study found no significant difference in intravascular injection rates between Touhy and Quincke needles during lumbar medial branch blocks (MBB). Neither needle type reduced injection time, radiation, or patient discomfort, suggesting needle choice does not impact these outcomes.

Area of Science:

  • Pain Management
  • Interventional Radiology
  • Anesthesiology

Background:

  • Inadvertent intravascular injection during lumbar medial branch blocks (MBB) can lead to inaccurate diagnoses of facet joint pain.
  • Previous research suggests needle type may influence intravascular injection rates.

Purpose of the Study:

  • To compare the incidence of intravascular injection between Quincke and Touhy needles during lumbar MBB.
  • To evaluate differences in injection time, radiation dose, and patient discomfort between the two needle types.

Main Methods:

  • A prospective randomized trial was conducted in an interventional pain management practice.
  • The incidence of intravascular contrast uptake was compared using real-time fluoroscopy during lumbar MBB with Touhy and Quincke needles.
  • Injection time, radiation dose, and patient discomfort were also assessed.

Main Results:

  • The incidence of intravascular injection was similar between the Touhy needle group (21.8%) and the Quincke needle group (21.2%).
  • The odds ratio for intravascular injection associated with needle type was 1.1.
  • Injection time, radiation dose, and patient discomfort were comparable between the needle groups.

Conclusions:

  • The incidence of intravascular injection during lumbar MBB is nearly 20% regardless of needle type (Touhy vs. Quincke).
  • Using Touhy needles did not decrease the rate of intravascular injection, injection time, radiation dose, or patient discomfort.
  • Needle selection does not appear to influence the safety or efficiency of lumbar MBB procedures in terms of these parameters.
Keywords:
Touhy needleintravascular injectionmedial branch blockQuincke needle

More Related Videos

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy03:59

Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy

Published on: January 10, 2019

7.3K
Lumbar Intrathecal Injection of Gene Therapy Vectors for Central Nervous System Targeting in Mice and Rats05:09

Lumbar Intrathecal Injection of Gene Therapy Vectors for Central Nervous System Targeting in Mice and Rats

Published on: May 16, 2025

981

Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
608
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
827
Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
955