Radiation safety: a focus on lead aprons and thyroid shields in interventional pain management

Summary
C-arm fluoroscopy is useful equipment in interventional pain management because it helps guide the correct direction of the needle for accurate injection and drug delivery. However, due to the increased use of C-arm fluoroscopy in various pain procedures, the risk of radiation exposure is a major concern for pain clinicians. The harmful biological effects of ionizing radiation on the human body are well known. Therefore, efforts must be made to reduce radiation exposure. Lead aprons with thyroid guards are the most basic radiation protection devices for interventional procedures and are very effective.

Lead radiation X-ray shielding

However, the radiation safety of the operator cannot be guaranteed because pain clinicians appear to lack sufficient interest, knowledge and awareness about radiation safety. Additionally, improper care and use of radiation protection equipment may result in an increased risk of radiation exposure. The purpose of this article was to review the radiation safety literature with a focus on lead aprons and thyroid shields and to make recommendations regarding such devices during fluoroscopy-guided C-arm procedures by pain clinicians.
INTRODUCTION
C-arm fluoroscopy is very important and useful for diagnosis and treatment in interventional pain management [1]. Ensures target specificity of a needle for precise injection and delivery of a drug through continuous visible X-ray imaging. However, the increased use of C-arm fluoroscopy in pain management has resulted in increased exposure to ionizing radiation. Pain physicians perform procedures close to the patient’s body and to the x-ray beam (the radiation source), making it difficult to avoid unwanted exposure to scattered radiation from the patient [2, 3, 4]. Therefore, efforts to reduce radiation exposure during pain management are very important. However, in some surveys, pain clinicians reported a lack of interest, awareness, and knowledge about radiation safety [5,6].

There are three main factors in reducing scattered radiation doses: exposure time, distance from the radiation source, and radiation protection. The most important of these factors is adequate shielding [7]. Based on these factors, the time required to use fluoroscopy should be reduced, the physician should be positioned as far as possible from the radiation source, and the physician should be protected with appropriate radiation protective equipment. These radiation protection devices include lead aprons, thyroid shields, radiation caps, gloves, lead glasses, lead barriers, and lead table or patient sheets. Of these, lead aprons and thyroid shields are the standard radiation safety shields for interventional medical personnel, including pain physicians [6,8]. In this review, we discuss basic strategies for reducing radiation exposure, as well as the proper use of lead aprons and thyroid shields in the management of interventional pain.
MAIN BODY
1. Methods
The literature review was carried out by searching database sources such as PubMed for publications from the last 10 years using the search terms “radiation protection and pain medicine”, “thyroid protector”, ” thyroid “,” thyroid protector “,” lead aprons “and” equivalent lead aprons “. Other relevant articles were also examined for more information.

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