Radiation Safety for Pain Physicians: Technique or Equipment

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Anatomic landmarks are useful for simple interven-tional techniques in pain clinics. However, for more accurate and efficacious procedures, several types of medical devices, such as CT, MRI, ultra-sonography and fluoroscopy, have been used. Fluoroscopy provides continuous visible images during a diagnostic or interventional procedure. It is very useful and effective, but ionizing radiation exposure is a major problem. The adverse effects of ionizing radiation on the human body include skin diseases, cataracts, and some cancerous conditions such as thyroid cancer or brain tumor [1]. table-side lead drapes are applied to protect the pain physicians during fluoroscopic procedures. In previous studies, radiation-protective aprons and thyroid shields were found to be the most widely used utilities for radiation safety [2,3]. Radiation-protective aprons, with an equivalent thickness of 0.25-0.35 mmPb, provide a radiation attenuation effect up to 90-95% [4]. In this issue of the Korean journal of pain, Kim et al. [5] present an effective method for reducing radiation during C-arm fluoroscopy-guided pain interventions. In the current study, they studied the radiation-protective efficiency of radiation-reducing gloves. They compared effective doses (EDs) from the two dosimeters that were measured at the side of the table (Group 1) and at a location 20 cm away from the side of the table (Group 2) with/with-out radiation-reducing gloves. The RAD-adjusted mean ED without the gloves was 35.6 μSv in Group 1 and 9.5 μSv in group 2. Meanwhile the RAD-adjusted mean ED with the gloves was 26.2 μSv in Group 1 and 7.2 μSv in group 2. They concluded that the radiation-reducing gloves decreased scatter radiation by 26.5% in Group 1 and 25.8% in Group 2. This result also showed that a longer distance of only 20 cm from the side of the table can reduce scatter radiation by 73.3%. Consequently, they recommended the method of pulling back the physician's hands, as this method can be a more effective and cost-effective means of radiation safety as compared to wearing radiation-reducing gloves. Radiation exposure is a very important and delicate issue for people who work in area of occupational radiation. The authors reported several papers about radiation safety and protection methods. They revealed the importance of the fluoroscopic mode during procedures [6]. …