Systemic effects of fluoroscopically guided epidural steroid injection with dexamethasone
10.3344/kjp.2019.32.3.178
- Author:
Woo Young KANG
1
;
Joon Woo LEE
;
Eugene LEE
;
Yusuhn KANG
;
Joong Mo AHN
;
Heung Sik KANG
Author Information
1. Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea. joonwoo2@gmail.com
- Publication Type:Original Article
- Keywords:
Complications;
Dexamethasone;
Drug-Related Side Effects and Adverse Reactions;
Epidural Space;
Fluoroscopy;
Incidence;
Low Back Pain;
Steroids
- MeSH:
Dexamethasone;
Drug-Related Side Effects and Adverse Reactions;
Epidural Space;
Fluoroscopy;
Flushing;
Follow-Up Studies;
Humans;
Incidence;
Interviews as Topic;
Low Back Pain;
Retrospective Studies;
Sleep Initiation and Maintenance Disorders;
Spine;
Steroids;
Urticaria
- From:The Korean Journal of Pain
2019;32(3):178-186
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Epidural steroid injections (ESIs) have been widely used in managing spinal pain. Dexamethasone has recently emerged as a useful drug in this setting, relative to particulate steroids, although the associated systemic effects have not been fully elucidated. This study aimed to investigate the incidences and types of systemic effects after fluoroscopically guided ESI with dexamethasone. METHODS: This retrospective study included 888 ESIs with dexamethasone (fluoroscopically guided at the cervical and lumbosacral levels) performed on 825 patients during January to June 2017. Data regarding systemic effects were collected via telephone interviews using a standardized questionnaire at 2 weeks after the procedure. Data on patient demographic, clinical, and procedural characteristics were collected and analyzed to identify factors that were associated with systemic effects. All statistical analyses were performed using the chi-squared test. RESULTS: Among the 825 patients, 40 patients (4.8%) experienced systemic effects during the 2-week follow-up period. The most common systemic effect was facial flushing (12 patients, 1.5%), which was followed by urticaria (7 patients, 0.8%) and insomnia (7 patients, 0.8%). A history of spine surgery was significantly associated with the occurrence of systemic effects (P = 0.036). Systemic effects were significantly more common for injections at the cervical level than at the lumbar level (P = 0.019). CONCLUSIONS: Approximately 4.8% of the patients who underwent ESI with dexamethasone experienced minor and transient systemic effects. These effects were more common in patients who had undergone a previous spine surgery or received a cervical ESI.
