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. 2023 Jul 17;31(3):e266060.
doi: 10.1590/1413-785220233103e266060. eCollection 2023.

THE USE OF ADHESIVE RADIOPAQUE GRIDS IN GENICULAR NERVE BLOCK BY RADIOSCOPY

Daniel Peixoto Leal  1 , Matheus Garcia Lopes Merino  1 , Muhamad Mustafa Atieh  2 , Vitor Henrique Campoy Guedes  2 , Jose Ricardo Pecora  1 , Camilo Partezani Helito  1
Affiliations

THE USE OF ADHESIVE RADIOPAQUE GRIDS IN GENICULAR NERVE BLOCK BY RADIOSCOPY

Daniel Peixoto Leal et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

The performance of genicular nerve block requires an imaging method to guide the procedure. Radioscopy has the disadvantage of being radiation dependent.

Objective: To assess whether the use of adhesive radiopaque grids reduce radiation exposure in these cases.

Methods: This is a cross-sectional study conducted with 23 orthopedists in which needles were positioned in a model with and without the use of adhesive radiopaque grids. The number of fluoroscopy shots necessary for proper positioning in three points (superior lateral, superior medial, and inferior medial) were registered.

Results: A statistical difference was observed in the three blocking points studied. The number of radioscopies required for these three points were 12.1 ± 2.5 in the group without grid and 5.0 ± 1.8 in the group with grid. The superior medial point presented the greatest numerical difference and the inferior medial point the smallest.

Conclusion: The use of adhesive radiopaque grids led to a statistically significant reduction in the number of radioscopies/fluoroscopies required to perform the genicular block. The use of this device increases the safety of the physician and patient by reducing radiation exposure in this procedure. Level of Evidence III, Level of Evidence II, Random Clinical Trial.

Para a realização do bloqueio de nervos geniculares é necessário guiar o procedimento por um método de imagem. A radioscopia possui a desvantagem de ser dependente de radiação.

Objetivo: Avaliar se o uso de máscaras localizadoras diminui a exposição à radiação nesses casos.

Métodos: Estudo transversal realizado com 23 ortopedistas, que realizaram o posicionamento de agulhas em um modelo com e sem o uso da máscara localizadora. Foi registrado o número de escopias necessárias para o posicionamento adequado em três pontos: superior lateral, superior medial e inferior medial.

Resultados: Foi observada diferença estatística nos três pontos de bloqueio analisados. O número de radioscopias necessárias nos três pontos somados foi de 12,1 ± 2,5, no grupo sem máscara, e 5,0 ± 1,8, no grupo com máscara. O ponto superior medial foi o que apresentou a maior diferença numérica, e o inferior medial a menor.

Conclusão: O uso da máscara localizadora reduziu de forma estatisticamente significativa o número de escopias necessárias para a realização do bloqueio genicular. O uso desse dispositivo aumenta a segurança do médico e do paciente por diminuir a exposição à radioscopia nesse procediment. Nível de Evidência III, Ensaio clínico randomizado aberto - Nível de recomendação B - nível de evidência 2b.

Keywords: Nerve Block; Orthopedic Surgeons; Peripheral Nerves.

PubMed Disclaimer

Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Fluoroscopy image of the anatomical model used in the study demonstrating the proper positioning of genicular block needles at the superomedial, superolateral, and inferomedial points.
Figure 2
Figure 2. Orthopedist positioning the genicular block needles under fluoroscopy on the previously positioned model. It is possible to observe the adhesive radiopaque grid used in the study.
Figure 3
Figure 3. Adhesive radiopaque grid (X-GRID radiopaque adhesive, Target Tape, Canada) used in the study on genicular nerve block.
Figure 4
Figure 4. Fluoroscopy image of the model used in the study demonstrating the placement of needles at the superomedial and superolateral points guided by the X-Grid.
See this image and copyright information in PMC

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