Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Use of Methylprednisolone in Epidural Analgesia

Use of Methylprednisolone in Epidural Analgesia Abstract To the Editor. —The warnings of methylprednisolone use in epidural analgesia by Dr Nelson1 raises important issues for physicians caring for patients with chronic low-back pain. As he noted, there is no doubt that polyethylene glycol is neurotoxic, and is the likely cause for sterile meningitis when methylprednisolone is injected in the subarachnoid space. It is noteworthy that corticosteroids have not been approved for intrathecal use by the Food and Drug Administration. The package insert for methylprednisolone acetate (Depomedrol, Upjohn) states "not recommended" for subarachnoid injection.A large body of clinical experience suggests the use of local anesthetics and steroids in the epidural space is a safe and effective treatment for the conservative management of low back pain in which there is reasonable evidence that inflammation of nerve roots is the cause of the symptoms. Two steroids, methylprednisolone acetate, 40 to 80 mg (Depomedrol, Upjohn), and triamcinolone diacetate References 1. Nelson P. Dangers from methylprednisolone acetate therapy by intraspinal injection . Arch Neurol . 1988;45:804-806.Crossref 2. Wood KM, Arguelles J, Norenberg MD. Degenerative lesions in rat sciatic nerves after local injection of methylprednisolone in sterile aqueous solution . Regional Anesth . 1980;5:13-15. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Use of Methylprednisolone in Epidural Analgesia

Loading next page...
 
/lp/american-medical-association/use-of-methylprednisolone-in-epidural-analgesia-eNoIuk2UCR
Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1989.00520470017014
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —The warnings of methylprednisolone use in epidural analgesia by Dr Nelson1 raises important issues for physicians caring for patients with chronic low-back pain. As he noted, there is no doubt that polyethylene glycol is neurotoxic, and is the likely cause for sterile meningitis when methylprednisolone is injected in the subarachnoid space. It is noteworthy that corticosteroids have not been approved for intrathecal use by the Food and Drug Administration. The package insert for methylprednisolone acetate (Depomedrol, Upjohn) states "not recommended" for subarachnoid injection.A large body of clinical experience suggests the use of local anesthetics and steroids in the epidural space is a safe and effective treatment for the conservative management of low back pain in which there is reasonable evidence that inflammation of nerve roots is the cause of the symptoms. Two steroids, methylprednisolone acetate, 40 to 80 mg (Depomedrol, Upjohn), and triamcinolone diacetate References 1. Nelson P. Dangers from methylprednisolone acetate therapy by intraspinal injection . Arch Neurol . 1988;45:804-806.Crossref 2. Wood KM, Arguelles J, Norenberg MD. Degenerative lesions in rat sciatic nerves after local injection of methylprednisolone in sterile aqueous solution . Regional Anesth . 1980;5:13-15.

Journal

Archives of NeurologyAmerican Medical Association

Published: Nov 1, 1989

References