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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

396
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
396
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

551
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
551

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Related Experiment Video

Updated: May 8, 2025

Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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Optimizing Cervical Epidural Steroid Injections: A Case Report.

Jamal Hasoon1, Kenzie Chu2, Wesley Chu2

  • 1Department of Anesthesiology, Critical Care, and Pain Medicine The University of Texas Health Science Center at Houston.

Orthopedic Reviews
|December 26, 2024
PubMed
Summary
This summary is machine-generated.

Cervical epidural steroid injections (CESI) can effectively treat severe cervical radiculopathy when conservative methods fail. Precise needle placement and contrast assessment are crucial for successful outcomes in this nerve compression condition.

Keywords:
cervical radiculopathychronic painepidural steroid injectionsinterventional pain

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Area of Science:

  • Neurology
  • Pain Medicine
  • Interventional Radiology

Background:

  • Cervical radiculopathy involves upper limb pain, numbness, and weakness due to nerve root compression.
  • Conservative treatments like physical therapy and analgesics are standard but may be insufficient for severe cases.
  • Cervical epidural steroid injections (CESI) offer an alternative when conservative management fails.

Purpose of the Study:

  • To report a case of severe cervical radiculopathy treated with interlaminar CESI.
  • To emphasize the importance of accurate contrast flow and needle placement in CESI procedures.
  • To highlight the efficacy of CESI in managing refractory cervical radiculopathy.

Main Methods:

  • A female patient with severe C5/6 and C6/7 radiculopathy unresponsive to conservative therapy was treated.
  • An interlaminar CESI was initially attempted at C7/T1, but contrast flow was suboptimal.
  • Needle repositioning to the C6/C7 interspace improved contrast distribution and targeted the affected nerve roots.

Main Results:

  • The patient experienced a significant 90% reduction in symptoms within three weeks post-procedure.
  • Successful symptom relief was achieved after optimizing needle placement and contrast visualization.
  • The case demonstrates the effectiveness of CESI when technically performed correctly.

Conclusions:

  • Accurate contrast flow assessment and precise needle placement are critical for the success of cervical epidural steroid injections.
  • CESI can be a highly effective treatment for severe cervical radiculopathy that does not respond to conservative measures.
  • This case underscores the value of interventional pain management techniques in achieving substantial patient recovery.