Avoiding Complications During Interventional Procedures

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Discussing prior history of complications with patients is essential.
Discussing prior history of complications with patients is essential.

Complications related to anesthetic and other medications used during interventional procedures can be allergic or toxic, so the clinician performing the intervention must pay close attention to dose and location of medications being administered as well as additives to avoid these issues.

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Reactions or other side effects usually occur within 30 to 60 minutes of injection.

When dealing with a patient with a previous iodinated contrast agent reaction, pretreatment should be considered.

When there is a reaction, treatment should start promptly and should include:  cessation of the medication, oxygen, antihistamines, administration of H1 and H2 blockers and steroids where appropriate and steroids if necessary.

Potential adverse events associated with contrast agents, include chemotoxic reactions like thyrotoxicosis, or nephrotoxicity; hypoosmolar reactions; and allergic reactions.

Corticosteroids are also commonly used during interventional pain procedures, and it is important to keep in mind adverse reactions to these agents as well. Cortisone, hydrocortisone, prednisone, methylprednisolone, and longer-acting agents like dexamtheasone and betametahasone all have been used during procedures that address painful conditions.

Potential complications associated with corticosteroid use include: elevated blood pressure, mood changes, facial flushing, menstrual irregularities, gastritis, hypothalamic adrenal axis, Cushing's Syndrome, bone demineralization, steroid weakness, and allergic reactions.

DISCLAIMER: Dr. Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN.This blog and related podcast is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment.

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