Comparison of Radiation Exposure on the Control Panel Side Versus the Opposite Side During C-Arm Fluoroscopy-Guided Blocks: Randomized Controlled Trial

C-arm fluoroscopy-guided blocks are widely performed in pain management but expose physicians to ionizing radiation. Although a physician’s position relative to the C-arm may influence exposure levels, the clinical impact of standing specifically on the control panel side remains under-investigated in a randomized setting. In this prospective randomized controlled trial, procedures were assigned to either Group P (physician on the control panel side) or Group C (physician on the opposite side). Equivalent effective dose (EED) was measured at the physician’s chest and the C-arm table using digital dosimeters. A linear mixed-effects model was employed to account for physician-level clustering. A total of 331 procedures were analyzed. The EED at the physician’s chest was significantly lower in Group P (5.0 [3.0–8.0] μSv) than in Group C (25.0 [17.0–45.0] μSv), P < 0.001. Table-level EED was also significantly lower in Group P (18.0 vs. 35.0 μSv, P = 0.002). The chest-to-table EED ratio was reduced in Group P (0.4 vs. 0.7, P < 0.001). There were no significant differences in radiation absorbed dose or fluoroscopy time between the two groups. Standing on the control panel side significantly reduces occupational radiation exposure, particularly at the chest level, compared to standing on the opposite side. This positional adjustment does not compromise procedural efficiency, making it a highly practical strategy for enhancing radiation safety during C-arm fluoroscopy-guided blocks.