脊椎神经神经神经病学副作用 脊椎神经外注类固醇注射后:一个前性队列研究
Suzanna Shermon1, John Maclean2, Richard Shim2
1Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH.
Pain physician
|March 20, 2024
概括
在 epidural 类固醇注射 (ESI) 后的神经心理症状很少见. 患有精神病史的患者可能会出现刺激性增加,而多次注射水平可能会延长症状.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 疼痛管理 疼痛管理
背景情况:
- 中枢神经系统的类固醇受体会影响情绪和压力等情绪.
- 皮质类固醇可以加速情绪变化.
- 现有的研究主要集中在口服/静脉注射皮质类固醇的神经精神疾病影响,而不是外周.
研究的目的:
- 为了调查经外注类固醇注射 (ESI) 后的神经精神病学副作用.
- 为了确定患者病史中可能会恶化ESI相关症状的因素.
主要方法:
- 在城市学术医院进行的前性观察队列研究.
- 包括接受 lumbosacral ESI (ILESI,尾部,TFESI) 的患者.
- 通过患者采访,在注射后24小时和一周评估神经精神症状.
主要成果:
- 患有精神病史的患者在ESI后24小时报告了更多的不安和易怒.
- 男性性别,间层ESI (ILESI) 和两级注射显着与一周内更多的总体症状有关.
- 建议在皮质类固醇剂量和症状持续时间之间存在潜在的相关性.
结论:
- 在ESI后出现的神经心理症状并不常见,但某些因素会增加风险.
- 精神病史与短期易怒性有关;较高的注射量可能与较长的症状持续时间相关.
- 由于研究的局限性,包括单中心设计和有限的随访,需要进行进一步的研究.
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