Abstract: Objective of this study was to assess the adequacy of relief provided by Nerve Root Block for Lumbar Radicular pain. If successful, this treatment can obviate the need for surgery considering the favourable natural history of this pathology.

We studied 64 patients who had this injection, from February 2000 to July 2001. These patients had clinical and radiographic confirmation of nerve root compression and were followed up at 2 and 6 weeks post injection and then at an average of 10 months by a questionnaire, which addressed patient satisfaction with injection treatment and pre-injection and present Low Back Outcome Score and Pain intensity on Visual Analogue Scale.

Overall, out of 64 patients injected, at 10 months follow-up, 50% (n=32) were satisfied with the treatment, 42% (n=27) injections failed and 8% (n=5) had incomplete follow-up. Pain intensity as measured on Visual Analogue Scale decreased from pre-injection mean value of 9.1 to post injection value of 4.9 the difference being statistically significant (p< 0.01). The Low Back Outcome Score increased from mean of 43 to 61, again the difference being statistically significant (p< 0.01).

Nerve Root Block is an effective therapeutic tool for Lumbar Radicular pain and should be recommended as the initial treatment of choice for this condition since it can provide persistent relief to the point that the patient does not require surgery.

In Ireland and the United Kingdom, there were 22 deaths as a direct result of blood transfusion during the period October 1996 to September 1998. Added to this there were 366 complications directly related to blood transfusion. With the introduction of a Haemovigilance Nurse and changing surgical personnel we were anxious to review transfusion rates in our Regional Orthopaedic Centre for the period January 1999 to July 2000.

All patients undergoing primary or revision arthroplasty in our Regional Orthopaedic Unit during the study period were reviewed. 459 primary or revision arthroplasties were performed in the study period.

Prior to the introduction of a Haemovigilance Nurse, transfusion rates for primary arthroplasties averaged 1. 41 units/patient, with 74% of patients being transfused. After the introduction, transfusion rates averaged 0. 51 units/patient, with 31% of patients being transfused.

Prior to the introduction of a Haemovigilance Nurse revision arthroplasties averaged 2. 5 units/patient, with 100% of patients being transfused. After the introduction transfusion rates averaged 1. 2 units/patient, with 62% of patients being transfused. There was a statistically significant difference between transfusion rates prior to and post the introduction of a Haemovigilance Nurse (p< 0. 005).

In the current climate post the Finlay Tribunal in Ire-land and the resultant increased public awareness, transfusing a patient without justifiable cause is no longer acceptable. Patients in this Unit are now transfused according to clinical needs and accurate measurement of intra-operative and post-operative blood loss, compared to their calculated maximum allowed blood loss (MABL). Our new transfusion protocol is working well without compromising patient care.