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Systemic effects of epidural dexamethasone injections
J F Maillefert1, S Aho, M C Huguenin
1Department of Rheumatology, General Hospital, Dijon, France.
Revue Du Rhumatisme (English Ed.)
|June 1, 1995
Summary
A single epidural injection of dexamethasone acetate can cause temporary adrenal suppression, indicating systemic absorption. However, significant side effects like hypercorticism are typically absent after this steroid treatment.
Area of Science:
- Endocrinology
- Pain Management
- Pharmacology
Background:
- Epidural corticosteroid injections are common for sciatica.
- Potential systemic absorption and effects of epidural dexamethasone are not fully understood.
Purpose of the Study:
- To assess the systemic endocrine effects of a single epidural injection of dexamethasone acetate.
Main Methods:
- Nine patients with sciatica received a 15 mg epidural injection of dexamethasone acetate.
- Serum cortisol, ACTH, urinary free cortisol, glucose, lipids, and electrolytes were measured at baseline and on days 2, 7, and 21.
- Blood pressure was monitored on days 0, 2, and 7.
Main Results:
- Serum cortisol, ACTH, and urinary cortisol levels significantly decreased on days 2 and 7 post-injection, returning to normal by day 21.
- No significant changes were observed in fasting glucose, triglyceride, cholesterol, sodium, or potassium levels.
- Blood pressure remained stable throughout the study period.
Conclusions:
- A single 15 mg epidural dexamethasone acetate injection leads to transient adrenal suppression, confirming systemic absorption.
- The observed adrenal suppression is temporary and does not typically result in clinical signs of hypercorticism.