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B: patients with pain relief of less than 6 months, Group C: patients with pain relief of more than 6 months) who failed to the medical treatment were included to undertake a fluoroscopic-guided TFESI. Prior to treatment, the VAS (visual analogue scale), ODI (Oswestry disability index), BDI (Beck depression inventory), and BAI (Beck anxiety inventory) scores were determined to evaluate the degre e of pain, disability, and psychological status. The VAS and ODI scores were used to assess the degree of pain r elief. To identify the total duration of pain relief, regular outpatient visits for six months were conducted, and for the patients who were not able to visit the outpatient clinic regularly, outcome was assessed by telephone interviews after six months. Results: The dural sac cross-sectional area (DSCSA), ODI, pain duration, BDI, BAI, and age showed similar distribution for patients in the A, B, and C groups. Conclusions: The DSCSA, ODI, pain duration, BDI, BAI, and age were not associated with the therapeutic duration of TFESI in lumbar spinal stenosis patients. (Korean J Pain 2008; 21: 136�� 142)

Background: This study was performed to evaluate the correlations between lumbar epidural depth by MRI and physical measurements. Methods: The anatomy of the lumbar epidural space was evaluated using MRI scans of 121 patients (93 male and 31 female). Epidural depth was measured from the skin to the center of the posterior epidural space at the L3-4 and L 4-5 levels by two methods (in a parallel line to the lumbar spinous process [SKEP I] and in a vertical line to the long axis of the spine [SKEP II]). Physical measurements such as weight, height, foot size, and waist were measured, other physical measurements such as the Ponderal index (PI), body mass index (BMI), and obesity (Broca's index) were calculated. Results: Significant correlations between depth from the skin to the posterior epidural space were found for Ponderal index(PI), body mass index (BMI), obesity (Broca's index), weight, waist circumference, height, and foot size. The depth from the skin to the supraspinous ligament correlated with BMI, obesity (Broca's index), PI, weight, and waist circumference. The depth from the supraspinous ligament to the posterior epidural space were found to correlate with height and foot size. Conclusions: PI had a higher predictive value for epidural depth than the other physical measurements.

Background: Propofol is a good induction agent. but it has a disadvantage of pain on intravenous injection. Pretreatment of metoclopramide or lidocaine have been reported to reduce pain on injection. thus, we have evaluated the quantity and quality of anagesic effect of metoclopramide and lidocaine. We observed differences in quality of pain according to venous cannula sizes and intravenous injection sites as well as nausea and vomiting in the postoperative state. Methods: Eighty patients scheduled for an elective operation by general anesthesia were chosen according to ASA (I or II) and divided into four groups randomly. Each group was injected through venous cannulas with normal saline (control group), metoclopramide 5 mg (group 1), metoclopramide 10 mg (group 2), or 2% lidocaine 40 mg (group 3) respectively. Then, propofol was injected of a 2 mg/kg dose with 0.5 ml/sec to all groups and we asked questions about injection pain after 10 seconds. Results: Pain relief was shown in all groups compared with the control. but metoclopramide 10 mg and lidocaine 40 mg pretreatment groups showed significant pain reief. Pain was relieved significantly when the drug was injected in the antecubital area. Postoperative nausea and vomiting were not observed. Conclusions: Metoclopramide 10 mg or lidocaine 40 mg pretreatment to induction by propofol revealed a good analgesic effect for propofol injection pain.