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Related Experiment Videos

Adrenal suppression following extradural steroids.

S Jacobs, P T Pullan, J M Potter

    Anaesthesia
    |October 1, 1983
    PubMed
    Summary

    Single lumbar extradural injections of methylprednisolone acetate for sciatica suppressed adrenal function for up to 3 weeks. This suggests minimizing steroid dose and frequency to avoid hypothalamic/pituitary/adrenocortical axis suppression.

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    Area of Science:

    • Endocrinology
    • Pain Management
    • Neurology

    Background:

    • Chronic sciatica is often treated with epidural steroid injections.
    • Methylprednisolone acetate is a common corticosteroid used for its anti-inflammatory properties.

    Purpose of the Study:

    • To evaluate the impact of a single lumbar extradural injection of methylprednisolone acetate on adrenocortical function.
    • To assess systemic absorption and adrenal suppression following the procedure.

    Main Methods:

    • 12 patients with chronic sciatica received an 80 mg lumbar extradural injection of methylprednisolone acetate.
    • Plasma cortisol levels were monitored post-injection.
    • Adrenal response to synthetic adrenocorticotrophin (ACTH) was tested.

    Main Results:

    • No systemic absorption of methylprednisolone acetate was detected.
    • Marked suppression of plasma cortisol levels persisted for up to 3 weeks.
    • The adrenal cortex's capacity to secrete cortisol in response to ACTH was diminished.

    Conclusions:

    • Single extradural methylprednisolone acetate injections can suppress the hypothalamic/pituitary/adrenocortical axis.
    • Minimizing steroid dose and frequency is recommended.
    • Patients require consideration for steroid cover during stressful procedures like surgery.

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