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August 1928

INTRACTABLE CHRONIC PAIN IN THE LOWER SEGMENTS OF THE BODYRELIEF BY MEANS OF SACRAL EPIDURAL INJECTIONS

Arch NeurPsych. 1928;20(2):336-344. doi:10.1001/archneurpsyc.1928.02210140104008
Abstract

The method of epidural injections was evolved, early in the century, separately by Cathelin1 and Sicard; its original application was for the relief of enuresis, in which it proved of doubtful value. Some years later, the method was revived in America (in the Mount Sinai Hospital, the Mayo Clinic and in other institutions) in the treatment of intractable sciatica.

TECHNIC  The procedure is as follows:The patient is placed in the knee-chest or knee-elbow position, though I have since found the prone position easier for the patient. The sacrococcygeal area is washed with alcohol, then painted with iodine. At the coccygeal end of the sacrum there is a small central depression between two lateral tubercles. Into this depression a preliminary injection of 2 or 3 cc. of 1 per cent procaine hydrochloride is made. A large needle—up to lumbar puncture size—is then inserted in the midline, parallel with the

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