宫跨内外皮质类固醇注射的安全性
William J Beckworth1, Gilad M Ghanbari2, Eduardo Lamas-Basulto2
1AdventHealth, USA. 50 Hospital Drive, Hendersonville, NC, 28792, USA.
Interventional pain medicine
|September 6, 2024
概括
使用非颗粒类固醇的宫外注射 (TFESI) 对于疼痛管理是安全有效的. 这项研究没有发现灾难性并发症,大多数患者经历了疼痛缓解.
科学领域:
- 疼痛管理 疼痛管理
- 神经学 神经学
- 干预性疼痛医学 干预性疼痛医学
背景情况:
- 美国食品和药物管理局2014年的警告强调了与外围注射类固醇相关的罕见神经系统风险,特别是在宫外围注射 (TFESI) 中.
- 由于历史上的并发症,人们仍然担心宫TFESI的安全性,这些并发症通常与颗粒状类固醇配方有关.
- 转向非颗粒类固醇的转变旨在减轻这些风险.
研究的目的:
- 评估使用非颗粒物类固醇配方的宫TFESI的安全性和有效性.
- 评估宫后灾难性并发症的发生率.
- 分析患者的结果和与这些程序相关的副作用.
主要方法:
- 2004年至2021年期间使用CPT代码64479.9进行的宫TFESI的回顾性审查.
- 向医生和董事询问灾难性并发症 (中风,脊髓损伤,死亡) 的情况.
- 连续200个宫性TFESI的二次分析,通过临床文档检查即时和延迟的副作用.
主要成果:
- 超过6000个宫TFESI被执行,报告没有任何灾难性并发症.
- 在200项手术的子集中,85.5%的患者经历了疼痛的减少,平均疼痛得分减少了3.7分.
- 轻微的短暂副作用包括疼痛增加 (3.5%),头痛,失眠,短暂的麻木和短暂的高血压;没有注意到严重的不良事件.
结论:
- 使用非颗粒类固醇的宫TFESI显示出有利的安全概况.
- 这些发现与当前的医学共识和关于在外周注射中使用类固醇的建议一致.
- 非颗粒类固醇似乎是宫TFESI的安全选择,支持其继续使用.
相关概念视频
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
422
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...
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...
422
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
592
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...
592