Coagulation management in epidural steroid injection

Area of Science:

• Anesthesiology
• Pain Management
• Neurology

Background:

• Epidural corticosteroid injections (ESI) are frequently utilized for managing chronic spinal pain.
• A comprehensive review on the coagulation management of ESI is lacking.
• Potential risks, such as hematoma formation, necessitate careful consideration of coagulation status.

Purpose of the Study:

• To conduct a literature review of English-language articles on coagulation management in human epidural corticosteroid injections.
• To synthesize current knowledge regarding the safe administration of ESI concerning patient coagulation.

Main Methods:

• Systematic literature search of MEDLINE and EMBASE databases up to 2012.
• Inclusion of articles using keywords: 'epidural', 'steroids', 'corticosteroids', 'glucocorticosteroids', 'coagulation', and 'haematoma'.
• Manual review of article references to identify additional relevant reports.

Main Results:

• Epidural steroid injections are a widely adopted technique for treating radicular pain.
• Evidence regarding specific coagulation management protocols for ESI remains inconclusive in the reviewed literature.
• The review underscores the importance of considering patient coagulation status prior to ESI.

Conclusions:

• Despite the prevalence of epidural steroid injections, meticulous coagulation management is essential.
• Further research may be needed to establish definitive guidelines for coagulation management during ESI.
• Ensuring appropriate coagulation management is critical for patient safety during ESI procedures.