Methods: Sixty patients undergoing TFESI were randomized to receive inhaled methoxyflurane or placebo before the procedure. Pain intensity was assessed using the Visual Analog Scale (VAS) at multiple time points during and after TFESI. Secondary outcomes included patient and physician satisfaction, as well as the incidence of adverse events. Renal and hepatic function parameters were evaluated pre- and post-procedure to assess safety. Results: The methoxyflurane group reported significantly lower worst pain scores during TFESI compared to placebo (3.33±0.70 vs. 5.71±1.23, p <0.01), with sustained pain relief for up to 60 minutes post-procedure. Adverse events in the methoxyflurane group were mild and self-limiting (dizziness, nausea/vomiting, and dry mouth), occurring in 10% of patients. No significant between-group differences were observed in renal or hepatic function indices. Patient satisfaction was significantly higher with methoxyflurane (96.67%) than with placebo. Conclusions Inhaled methoxyflurane is a safe and effective analgesic for TFESI, offering significant procedural pain reduction and high patient satisfaction, while maintaining a favorable safety profile.

Methods: We collected data on 118 patients who underwent TFESI without contrast versus TFESI with contrast for lumbar radiculopathy. The pain was evaluated using a Numerical Rating Scale (NRS) for pain at 5 minutes, 2 hours, 2 weeks, and 2 months. The functional status was assessed using the Oswestry Disability Index (ODI) score. The operation time and fluoroscopic dosage were also measured using this score. Results: Two groups of patients with radiculopathy were studied, comprising of 56 patients in the non-contrast group (NC group) and 62 patients in the contrast group (C group). There was a significant decrease in pain, as evaluated by NRS, in the C group compared to the NC group at 5 minutes post-procedure (3.39±1.54 vs. 3.86±0.72, with a p-value of 0.039). There was no significant difference in NRS scores at 2 hours, 2 weeks, and 2 months, as well as in ODI scores. The operation time and fluoroscopic dosage were lower in the group without contrast compared to the contrast group, with 12.58±3.30 minutes per level vs. 16.70±5.94 minutes per level (p <0.001) and 3.62±1.66 mGy vs. 5.32±2.74 mGy per level (p =0.014), respectively. No complications were reported in either group. Conclusions There is no difference in pain and functional outcome when treating lumbar radiculopathy with or without contrast using TFESI. The TFESI without contract technique has a shorter operation time and lower intra-operative fluoroscopic dosage without complications.