Complications of epidural steroid injection

This is a rare complication that may occur if a small hole is made in the fibrous sac and does not close up after the needle puncture. These small holes are only made in less than 1% of epidural injections and usually heal on their own. The spinal fluid inside can leak out, and when severe, the brain loses the cushioning effect of the fluid, which causes a severe headache when you sit or stand. These types of headaches occur typically about 2-3 days after the procedure and are positional - they come on when you sit or stand and go away when you lie down. If you do develop a spinal headache, it is OK to treat yourself. As long as you do not feel ill and have no fever and the headache goes away when you lay down, you may treat yourself with 24 hours of bed rest with bathroom privileges while drinking plenty of fluids. This almost always works. If it does not, contact the radiologist who performed the procedure or your referring physician. A procedure (called an epidural blood patch) can be performed in the hospital that has a very high success rate in treating spinal headaches.  

Kenalog in blood - Derby et al. "Size and aggregation of corticosteroids used for epidural injections"

  • Depo-Medrol also formed large aggregations in the study by Tiso et al [6]
  • Celestone Soluspan formed large aggregations only in the Derby et al study  [7 ]
  • It is speculated that these large aggregates occlude smaller vessels, and thus lead to infarction .
  • Injection of methylprednisolone vs dexamethasone vs prednisolone into the vertebral artery of pigs – see summary of study here

    Patients with mitral stenosis do not tolerate significant increases in heart rate, or tachycardia. On the other hand, tachycardia is common during cesarean section performed under general anesthesia, either during the induction or surgical stress. To avoid sharp changes in heart rate cesarean section is best performed under epidural anesthesia. The onset of epidural block is relatively slow, between ten and twenty minutes, and vasodilatation can be counteracted by administering vasoconstrictors, drugs that increase vascular tone. Analgesia achieved by epidural block is superior to that of general anesthesia, and as the result hemodynamic parameters remain stable during surgery, and the chance of adverse effects of anesthesia is reduced.

    Complications of epidural steroid injection

    complications of epidural steroid injection


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