Abstract：
BACKGROUND: Millions of interventional pain procedures are performed each year to address chronic pain. The increase in these procedures also raises the concern of health risks associated with ionizing radiation for interventional pain management physicians who perform fluoroscopy-guided operations. Some health concerns include cancers, cataracts, and even pregnancy abnormalities. Little is known regarding the long-term and cumulative effects of small radiation doses.
OBJECTIVE: The objective of this systematic review was to identify common body parts that are exposed to ionizing radiation during interventional pain procedures and examine methods to help physicians reduce their radiation exposure.
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist was used to comprehensively identify articles from 2 medical databases. The radiation dose to interventional pain management physicians obtained from relevant peer-reviewed articles were aggregated and used for analysis.
METHODS: PubMed was first used to collect the articles for two broad keyword searches of \"radiation exposure pain management\" and \"radiation exposure interventionalist\" with years ranging from 1956 - February 2023. EMBASE was also used to collect the articles for the two keyword searches of \"radiation exposure pain management\" and \"radiation exposure interventionalist\" with years ranging from 1969 - February 2023. This systematic approach yielded a total of 2,736 articles; 24 were included in our paper. The risk of bias for these articles was performed using the Cochrane Risk of Bias tool and the National Institutes of Health tool.
RESULTS: Through our systematic literature search, more than 3,577 patients were treated by 30 interventional pain management physicians. Some areas of exposure to radiation include the physician\'s neck, chest, groin, hands, and eyes. One common body region that is exposed to radiation is the chest; our review found that wearing lead aprons can lower the radiation dose by more than 95%. Wearing protective equipment and managing the distance between the operator and fluoroscope can both independently lower the radiation dose by more than 90% as well. Our literature review also found that other body parts that are often overlooked in regard to radiation exposure are the eyes and hands. In our study, the radiation dose to the outside (unprotected) chest ranged from 0.008 ± 27 mrem to 1,345 mrem, the outside neck ranged from 572 mrem to 2,032 mrem, the outside groin ranged from 176 mrem to 1,292 mrem, the hands ranged from 0.006 ± 27.4 mrem to 0.114 ± 269 mrem, and the eyes ranged from 40 mrem to 369 mrem. When protective equipment was worn, the radiation exposure to the inside chest ranged from 0 mrem to 108 mrem, the inside neck ranged from 0 mrem to 68 mrem, and the inside groin ranged from 0 mrem to 15 mrem.
CONCLUSIONS: Limitations of this study include its small sample size; only the radiation exposure of 30 interventional pain management physicians were examined. Furthermore, this review mainly consisted of observational studies rather than randomized clinical trials.
CONCLUSIONS: Implementing safety precautions, such as wearing protective gear, providing educational programs, and keeping a safe distance, demonstrated a significant decrease in radiation exposure. The experience of interventional pain management physicians also factored into their radiation exposure during procedures. Radiation is a known carcinogen, and more research is needed to better understand its risk to interventional pain management physicians.
OBJECTIVE: The objective of this systematic review was to identify common body parts that are exposed to ionizing radiation during interventional pain procedures and examine methods to help physicians reduce their radiation exposure.
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist was used to comprehensively identify articles from 2 medical databases. The radiation dose to interventional pain management physicians obtained from relevant peer-reviewed articles were aggregated and used for analysis.
METHODS: PubMed was first used to collect the articles for two broad keyword searches of \"radiation exposure pain management\" and \"radiation exposure interventionalist\" with years ranging from 1956 - February 2023. EMBASE was also used to collect the articles for the two keyword searches of \"radiation exposure pain management\" and \"radiation exposure interventionalist\" with years ranging from 1969 - February 2023. This systematic approach yielded a total of 2,736 articles; 24 were included in our paper. The risk of bias for these articles was performed using the Cochrane Risk of Bias tool and the National Institutes of Health tool.
RESULTS: Through our systematic literature search, more than 3,577 patients were treated by 30 interventional pain management physicians. Some areas of exposure to radiation include the physician\'s neck, chest, groin, hands, and eyes. One common body region that is exposed to radiation is the chest; our review found that wearing lead aprons can lower the radiation dose by more than 95%. Wearing protective equipment and managing the distance between the operator and fluoroscope can both independently lower the radiation dose by more than 90% as well. Our literature review also found that other body parts that are often overlooked in regard to radiation exposure are the eyes and hands. In our study, the radiation dose to the outside (unprotected) chest ranged from 0.008 ± 27 mrem to 1,345 mrem, the outside neck ranged from 572 mrem to 2,032 mrem, the outside groin ranged from 176 mrem to 1,292 mrem, the hands ranged from 0.006 ± 27.4 mrem to 0.114 ± 269 mrem, and the eyes ranged from 40 mrem to 369 mrem. When protective equipment was worn, the radiation exposure to the inside chest ranged from 0 mrem to 108 mrem, the inside neck ranged from 0 mrem to 68 mrem, and the inside groin ranged from 0 mrem to 15 mrem.
CONCLUSIONS: Limitations of this study include its small sample size; only the radiation exposure of 30 interventional pain management physicians were examined. Furthermore, this review mainly consisted of observational studies rather than randomized clinical trials.
CONCLUSIONS: Implementing safety precautions, such as wearing protective gear, providing educational programs, and keeping a safe distance, demonstrated a significant decrease in radiation exposure. The experience of interventional pain management physicians also factored into their radiation exposure during procedures. Radiation is a known carcinogen, and more research is needed to better understand its risk to interventional pain management physicians.
摘要：
背景：每年进行数以百万计的介入疼痛程序来解决慢性疼痛。这些程序的增加也引起了对进行荧光透视引导手术的介入疼痛管理医师与电离辐射相关的健康风险的关注。一些健康问题包括癌症，白内障,甚至怀孕异常。关于小辐射剂量的长期和累积影响知之甚少。
目的：本系统评价的目的是确定在介入疼痛过程中暴露于电离辐射的常见身体部位，并研究帮助医生减少辐射暴露的方法。
方法：使用系统评价和Meta分析(PRISMA)检查表的首选报告项目对来自2个医学数据库的文章进行综合鉴定。从相关同行评审的文章中获得的对介入疼痛管理医师的辐射剂量进行汇总并用于分析。
方法：PubMed首次用于收集“辐射暴露疼痛管理”和“辐射暴露干预学家”两个广泛关键词搜索的文章，年份从1956年到2023年2月。EMBASE还用于收集“辐射暴露疼痛管理”和“辐射暴露干预学家”两个关键词搜索的文章，这些关键词的年份从1969年到2023年2月不等。这种系统的方法总共产生了2736篇文章；我们的论文中包括了24篇。使用Cochrane偏差风险工具和美国国立卫生研究院工具进行这些文章的偏差风险。
结果：通过我们系统的文献检索，超过3,577例患者接受了30名介入疼痛管理医师的治疗.暴露于辐射的一些区域包括医生的脖子，胸部，腹股沟,手,和眼睛。暴露于辐射的一个常见的身体区域是胸部;我们的审查发现，佩戴铅围裙可以将辐射剂量降低95％以上。佩戴防护设备和管理操作员与荧光镜之间的距离都可以独立地将辐射剂量降低90％以上。我们的文献综述还发现，在辐射暴露方面经常被忽视的其他身体部位是眼睛和手。在我们的研究中,胸部外部(无保护)的辐射剂量范围从0.008±27mrem到1345mrem，外颈部从572mrem到2,032mrem，腹股沟外侧范围从176mrem到1292mrem，手的范围从0.006±27.4mrem到0.114±269mrem，眼睛范围从40mrem到369mrem。当防护装备被穿戴时,胸部内部的辐射暴露范围从0mrem到108mrem，颈内范围从0mrem到68mrem，腹股沟内侧范围从0mrem到15mrem。
结论：本研究的局限性包括样本量小；仅对30名介入疼痛管理医师的辐射暴露进行了检查。此外，本综述主要由观察性研究而非随机临床试验组成.
结论：实施安全预防措施，比如穿戴防护装备,提供教育项目，保持安全距离，证明了辐射暴露的显着减少。介入疼痛管理医生的经验也考虑了他们在手术过程中的辐射暴露。辐射是一种已知的致癌物质，需要更多的研究来更好地了解其对介入疼痛管理医生的风险。
目的：本系统评价的目的是确定在介入疼痛过程中暴露于电离辐射的常见身体部位，并研究帮助医生减少辐射暴露的方法。
方法：使用系统评价和Meta分析(PRISMA)检查表的首选报告项目对来自2个医学数据库的文章进行综合鉴定。从相关同行评审的文章中获得的对介入疼痛管理医师的辐射剂量进行汇总并用于分析。
方法：PubMed首次用于收集“辐射暴露疼痛管理”和“辐射暴露干预学家”两个广泛关键词搜索的文章，年份从1956年到2023年2月。EMBASE还用于收集“辐射暴露疼痛管理”和“辐射暴露干预学家”两个关键词搜索的文章，这些关键词的年份从1969年到2023年2月不等。这种系统的方法总共产生了2736篇文章；我们的论文中包括了24篇。使用Cochrane偏差风险工具和美国国立卫生研究院工具进行这些文章的偏差风险。
结果：通过我们系统的文献检索，超过3,577例患者接受了30名介入疼痛管理医师的治疗.暴露于辐射的一些区域包括医生的脖子，胸部，腹股沟,手,和眼睛。暴露于辐射的一个常见的身体区域是胸部;我们的审查发现，佩戴铅围裙可以将辐射剂量降低95％以上。佩戴防护设备和管理操作员与荧光镜之间的距离都可以独立地将辐射剂量降低90％以上。我们的文献综述还发现，在辐射暴露方面经常被忽视的其他身体部位是眼睛和手。在我们的研究中,胸部外部(无保护)的辐射剂量范围从0.008±27mrem到1345mrem，外颈部从572mrem到2,032mrem，腹股沟外侧范围从176mrem到1292mrem，手的范围从0.006±27.4mrem到0.114±269mrem，眼睛范围从40mrem到369mrem。当防护装备被穿戴时,胸部内部的辐射暴露范围从0mrem到108mrem，颈内范围从0mrem到68mrem，腹股沟内侧范围从0mrem到15mrem。
结论：本研究的局限性包括样本量小；仅对30名介入疼痛管理医师的辐射暴露进行了检查。此外，本综述主要由观察性研究而非随机临床试验组成.
结论：实施安全预防措施，比如穿戴防护装备,提供教育项目，保持安全距离，证明了辐射暴露的显着减少。介入疼痛管理医生的经验也考虑了他们在手术过程中的辐射暴露。辐射是一种已知的致癌物质，需要更多的研究来更好地了解其对介入疼痛管理医生的风险。
