Guidance Offered To Avoid Epidural-related Neurologic Complications

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Neurologic injury associated with epidural steroid injections has been recognized as a rare but serious complication.
Neurologic injury associated with epidural steroid injections has been recognized as a rare but serious complication.

A panel of experts from a number of medical organizations have issued a statement regarding epidural steroid injections, that is designed to prevent injuries and improve patient safety.

“Neurologic injury associated with epidural steroid injections has been recognized as a rare but serious complication for more than a decade, but there has been little agreement among practitioners on how best to minimize risks of injury – until now,” James Rathmell, MD, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston said in a press release.

The recommendations discourage the use of particulate versus nonparticulate steroids in certain situations, as well as make recommendations on infection control measures while administering the injections. 

Panel meetings for the group were facilitated by the FDA's Safe Use Initiative, which was created to promote public and private collaborations within the health care community aimed at improving safety.

“While the [group's] consensus statement is an important step forward for pain medicine, it is essential that as a field we perform the studies that will better elucidate the risks of epidural steroid injection, to further refine the group's suggestions,” Brian T. Bateman, MD, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital said in a press release. “Clinicians and patients need to be able to carefully consider the procedure's risks and benefits in deciding whether the balance of these factors is favorable given a patient's clinical condition, values, and preferences. A deeper understanding of the risks and benefits is urgently needed.”

Reference

1. Rathmell JP, et al. Anesthesiology. 2015; DOI:10.1097/ALN.0000000000000614

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