Passive Leg-Raising Test as a Predictor for the Drop in Blood Pressure After a Lumbar Epidural Block in the Pain Clinic: A Prospective Observational Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Exposure and Measurements
2.3. Transforaminal Lumbar Epidural Block
2.4. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Category | Variable | ||
---|---|---|---|
Personal Information | |||
Gender (F/M) | 20 (59%)/14 (41%) | ||
Age (years) | 63 [55–71] | ||
Height (cm) | 162 ± 10 | ||
Weight (kg) | 60 [53–73] | ||
Underlying dz | |||
None | 17 (50%) | ||
HTN | 12 (35%) | ||
IHD | 3 (9%) | ||
DM | 3 (9%) | ||
Dyslipidemia | 3 (9%) | ||
Diagnosis | |||
HNP | 18 (53%) | ||
Spinal stenosis | 12 (35%) | ||
FBSS | 2 (6%) | ||
Others | 2 (6%) | ||
Current medication | |||
None | 9 (26%) | ||
ARB | 8 (24%) | ||
BB | 6 (18%) | ||
CCB | 9 (26%) | ||
Antiplatelet | 9 (26%) | ||
Dyslipidemia medication | 3 (9%) | ||
DM medication | 2 (6%) | ||
Gabapentinoid | 13 (38%) | ||
NSAID | 11 (32%) | ||
Analgesic except NSAID | 3 (9%) | ||
Muscle relaxant | 7 (21%) | ||
TCA | 9 (26%) | ||
Epidural block | |||
Side | |||
Left | 15 (44%) | ||
Right | 11 (32%) | ||
Both | 8 (24%) | ||
Level | |||
L4 | 3 (9%) | ||
L5 | 10 (29%) | ||
S1 | 2 (6%) | ||
L4 & L5 | 4 (12%) | ||
L5 & S1 | 13 (38%) | ||
L4, L5 & S1 | 2 (6%) | ||
Number | |||
1 | 9 (26%) | ||
2 | 21(62%) | ||
3 | 3 (9%) | ||
4 | 1 (3%) | ||
VAS (0–100) | |||
Before epidural block | 60 ± 19 | ||
After epidural block | 5 [0–30] | ||
Change of BP | |||
between T0 and TPLRT | |||
Systolic | 9 ± 4 | ||
Diastolic | 4 [3–6] | ||
Mean | 6 ± 3 | ||
between T0 and T1 | |||
Systolic | 14 ± 8 | ||
Diastolic | 7 [3–13] | ||
Mean | 9 [6–14] | ||
Hypotension-related Sx | |||
Dizziness | 3 (9%) | ||
Nausea | 0 (0%) | ||
Vomiting | 0 (0%) | ||
Sweating | 0 (0%) |
T0 (Baseline) | TPLRT (at Passive Leg-Raising Test) | T1 (at 30 min After Epidural Block) | |
---|---|---|---|
Systolic BP (mmHg) | 120 ± 18 | 129 ± 18 | 106 ± 18 |
Diastolic BP (mmHg) | 65 ± 11 | 70 ± 10 | 57 ± 11 |
Mean BP (mmHg) | 85 ± 11 | 90 ± 12 | 74 ± 12 |
Mean BP Drop O | Mean BP Drop X | p Value | |||
---|---|---|---|---|---|
Gender (F/M) | 7/1 | 13/13 | 0.102 | ||
Age (years) | 71 [62–79] | 61 [37–69] | 0.035 | ||
Height (cm) | 155 ± 7 | 164 ± 10 | 0.017 | ||
Weight (kg) | 54 [52–69] | 60 [54–80] | 0.177 | ||
Underlying dz | |||||
None | 2 | 15 | 0.249 | ||
HTN | 6 | 6 | 0.013 | ||
IHD | 1 | 2 | 1.000 | ||
DM | 0 | 3 | 1.000 | ||
Dyslipidemia | 2 | 1 | 0.131 | ||
Diagnosis | |||||
HNP | 3 | 15 | 0.429 | ||
Spinal stenosis | 4 | 8 | 0.410 | ||
FBSS | 1 | 1 | 0.421 | ||
Others | 0 | 2 | 1.000 | ||
Current medication | |||||
None | 0 | 9 | 0.077 | ||
ARB | 4 | 4 | 0.066 | ||
BB | 3 | 3 | 0.126 | ||
CCB | 4 | 5 | 0.165 | ||
Antiplatelet | 2 | 7 | 1.000 | ||
Dyslipidemia | 2 | 1 | 0.131 | ||
DM | 0 | 2 | 1.000 | ||
Gabapentinoid | 4 | 9 | 0.69 | ||
NSAID | 1 | 10 | 0.227 | ||
Analgesic except NSAID | 0 | 3 | 1.000 | ||
Muscle relaxant | 2 | 5 | 1.000 | ||
TCA | 1 | 8 | 0.403 | ||
Epidural block | |||||
Side | 1.000 | ||||
Left | 4 | 11 | |||
Right | 2 | 9 | |||
Both | 2 | 6 | |||
Level | 0.767 | ||||
L4 | 1 | 2 | |||
L5 | 3 | 7 | |||
S1 | 1 | 1 | |||
L4 & L5 | 0 | 4 | |||
L5 & S1 | 3 | 10 | |||
L4, L5 & S1 | 0 | 2 | |||
Number | 0.242 | ||||
1 | 4 | 5 | |||
2 | 3 | 18 | |||
3 | 1 | 2 | |||
4 | 0 | 1 | |||
VAS (0–100) | |||||
Before epidural block | 68 ± 23 | 58 ± 17 | 0.196 | ||
After epidural block | 10 [0–28] | 5 [0] | 1.000 | ||
Change of BP between T0 and TPLRT | |||||
Systolic | 11 ± 5 | 8 ± 4 | 0.094 | ||
Diastolic | 4 [3–10] | 3 [2–6] | 0.110 | ||
Mean | 8 ± 4 | 5 ± 3 | 0.007 | ||
Change of BP between T0 and T1 | |||||
Systolic | 24 ± 7 | 11 ± 6 | <0.001 | ||
Diastolic | 20 [16–23] | 5 [3–8] | <0.001 | ||
Mean | 21 [20–23] | 7 [5–10] | <0.001 | ||
Hypotension-related Sx | |||||
Dizziness | 1 | 2 | 1.000 | ||
Nausea | 0 | 0 | - | ||
Vomiting | 0 | 0 | - | ||
Sweating | 0 | 0 | - |
Variables | Univariate Analysis | Multivariate Analysis | |||
---|---|---|---|---|---|
Odd Ratio (95% CI) | p Value | Odd Ratio (95% CI) | p Value | ||
Gender (F/M) | 7.000 (0.751–65.221) | 0.087 | |||
Age (years) | 1.090 (0.994–1.194) | 0.067 | |||
Height (cm) | 0.874 (0.773–0.989) | 0.032 | 0.783 (0.614–0.998) | 0.048 | |
Weight (kg) | 0.961 (0.898–1.027) | 0.237 | |||
Underlying disease | |||||
HTN | 10.000 (1.585–63.097) | 0.014 | 24.560 (1.131–533.504) | 0.042 | |
IHD | 1.714 (0.135–21.820) | 0.678 | |||
DM | 0 (0–0) | 0.999 | |||
Dyslipidemia | 8.333 (0.644–107.851) | 0.105 | |||
Diagnosis | |||||
HNP | 0.440 (0.086–2.244) | 0.323 | |||
Spinal stenosis | 2.250 (0.447–11.334) | 0.326 | |||
Failed back surgery syndrome | 3.571 (0.197–64.632) | 0.389 | |||
Others | 0 (0–0) | 0.999 | |||
Current medication | |||||
ARB | 5.500 (0.958–31.589) | 0.056 | |||
BB | 4.600 (0.709–29.841) | 0.110 | |||
CCB | 4.200 (0.771–22.869) | 0.097 | |||
Antiplatelet | 0.905 (0.147–5.583) | 0.914 | |||
Antihyperlipidemic Drugs | 8.333 (0.644–107.85) | 0.105 | |||
DM medication | 0 (0–0) | 0.999 | |||
Gabapentinoid | 1.889 (0.380–9.395) | 0.437 | |||
NSAIDs | 0.229 (0.024–2.146) | 0.196 | |||
Analgesic except NSAID | 0 (0–0) | 0.999 | |||
Muscle Relaxants | 1.400 (0.215–9.121) | 0.725 | |||
TCA | 0.321 (0.034–3.064) | 0.324 | |||
Injection side | |||||
Left | 6.559 (0.242–177.823) | 0.229 | |||
Right | 1.364 (0.278–6.683) | 0.702 | |||
Both | 1.111 (0.176–7.011) | 0.911 | |||
Injection level | |||||
L4 | 1.714 (0.135–21.820) | 0.678 | |||
L5 | 1.629 (0.306–8.679) | 0.568 | |||
S1 | 3.571 (0.197–64.632) | 0.389 | |||
L4 & L5 | 0 (0–0) | 0.999 | |||
L5 &S1 | 0.960 (0.187–4.924) | 0.961 | |||
L4, L5 & S1 | 0 (0–0) | 0.999 | |||
Injection Number | 0.425 (0.107–1.692) | 0.225 | |||
The number of injection levels | 0.369 (0.081–1.678) | 0.197 | |||
Injection agents | |||||
Ropivacaine | 0.918 (0.800–1.054) | 0.225 | |||
Dexamethasone | 0.710 (0.409–1.234) | 0.225 | |||
Hyaluronidase | 0.998 (0.996–1.001) | 0.225 | |||
Change of BP between T0 and TPLRT | 0.725 | ||||
Systolic | 1.178 (0.968–1.434) | 0.103 | |||
Diastolic | 1.171 (0.931–1.471) | 0.177 | |||
Mean | 1.426 (1.058–1.922) | 0.020 | 1.653 (1.058–2.581) | 0.027 |
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Kim, C.-L.; Hong, S.-W.; Jung, Y.-D.; Jung, S.-Y.; Kim, S.-H. Passive Leg-Raising Test as a Predictor for the Drop in Blood Pressure After a Lumbar Epidural Block in the Pain Clinic: A Prospective Observational Study. J. Clin. Med. 2025, 14, 2629. https://doi.org/10.3390/jcm14082629
Kim C-L, Hong S-W, Jung Y-D, Jung S-Y, Kim S-H. Passive Leg-Raising Test as a Predictor for the Drop in Blood Pressure After a Lumbar Epidural Block in the Pain Clinic: A Prospective Observational Study. Journal of Clinical Medicine. 2025; 14(8):2629. https://doi.org/10.3390/jcm14082629
Chicago/Turabian StyleKim, Cho-Long, Seung-Wan Hong, Yun-Do Jung, Sung-Yeon Jung, and Seong-Hyop Kim. 2025. "Passive Leg-Raising Test as a Predictor for the Drop in Blood Pressure After a Lumbar Epidural Block in the Pain Clinic: A Prospective Observational Study" Journal of Clinical Medicine 14, no. 8: 2629. https://doi.org/10.3390/jcm14082629
APA StyleKim, C.-L., Hong, S.-W., Jung, Y.-D., Jung, S.-Y., & Kim, S.-H. (2025). Passive Leg-Raising Test as a Predictor for the Drop in Blood Pressure After a Lumbar Epidural Block in the Pain Clinic: A Prospective Observational Study. Journal of Clinical Medicine, 14(8), 2629. https://doi.org/10.3390/jcm14082629