Decadron epidural steroid injection

Commonly cited incidence numbers in many textbooks have ranged from % to 11%. 6,7 Yet a recent prospective study by Kim et al aimed to further elucidate this issue. 8 Kim and his team enrolled 150 patients who underwent interlaminar epidural corticosteroid injections with 16 mg of dexamethasone. They reported that 42 of the 150 patients (28%) experienced self-reported flushing, most of which occurred after discharge (30 of 42). Interestingly, 67% of those who reported flushing were female; all events resolved within 48 hours of onset.

De Marchis, ., Lantigua, H., Schmidt, ., Lord, ., Velander, ., Fernandez, A., …Mayer, . (2014). Impact of premorbid hypertension on haemorrhage severity and aneurysm rebleeding risk after subarachnoid haemorrhage. Journal of Neurology, Neurosurgery, and Psychiatry , 85 (1), 56–59.

  • In a retrospective cohort study among 1,312 patients treated for subarachnoid hemorrhage, 49% of patients had hypertension, which was associated with a times increased risk of mortality at 3 months (95% CI, to ; p = ). In this study, % of patients with hypertension died within 3 months of the initial hemorrhage compared to % of patients without hypertension ( p < ).
  • Patients with hypertension presented more frequently with Grade 4 or 5 subarachnoid hemorrhage (% versus %; p < ). Hypertensive patients were also times more likely to have an episode of rebleeding (95% CI, to ; p = ) and times more likely to develop renal failure while hospitalized (95% CI, to ; p < ).

It Should Be Emphasized that Dosage Requirements Are Variable and Must Be Individualized on the Basis of the Disease Under Treatment and the Response of the Patient. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage that maintains an adequate clinical response is reached. Situations that may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the disease process, the patient's individual drug responsiveness, and the effect of patient exposure to stressful situations not directly related to the disease entity under treatment. In this latter situation, it may be necessary to increase the dosage of the corticosteroid for a period of time consistent with the patient's condition. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.

Decadron epidural steroid injection

decadron epidural steroid injection


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