5/21/2023 0 Comments Por que da hipoLIMITATIONS: The sample size enrolled might be too small to perceive possible rare side effects related to the procedure. Patients also reported experiencing adverse effects within the 3 days following intervention most complained of headaches, insomnia, hiccups, flushing, and increased radicular pain. The most common adverse effects were numbness and tingling in the limb, which developed in 19 patients (11.95%) followed by perineal pruritus that occurred in 7 cases (4.4%). RESULTS: Of the 150 patients enrolled, 31 patients (19.5%) experienced adverse effects within the first 30 minutes following the intervention. Intensity and duration of side effects were recorded. The occurrence of adverse effects in patients in the 2-week time period following interventions was monitored through a set of questionnaires followed up by phone calls scheduled for 1 day, day 3, and day 14. METHODS: One hundred fifty consecutive patients receiving TFESI for the management of radicular and axial spinal pain at the cervical, lumbar, and sacral levels with dexamethasone using fluoroscopic guidance with digital subtraction technology were enrolled. SETTING: A spine center affiliated with a rehabilitation hospital. STUDY DESIGN: Prospective, observational study. OBJECTIVE: To evaluate immediate and acute adverse effects following TFESI with dexamethasone. The use of dexamethasone in TFESIs is relatively new therefore, immediate and acute adverse effects that it may cause are not fully updated. We suggest that continuous cervical epidural block is an effective treatment for intractable hiccups.īACKGROUND: Transforaminal epidural steroid injections (TFESI) are widely used for the conservative treatment of radicular pain. No other adverse effects were reported.Ĭontinuous C3–C5 level cervical epidural block has a successful remission rate. One patient complained of dizziness that subsided. When the hiccups stopped and did not recur for 48 hours, the catheter was removed.Ĭumulative complete remission rates were 60.71% after the first cervical epidural block, 92.86% after the second, and 100% after the third. A 6-mL bolus of 0.25% ropivacaine was injected, and a continuous infusion of 4 mL/h of ropivacaine was administered through the epidural catheter using an infuser containing 0.75% ropivacaine (45 mL ropivacaine and 230 mL normal saline). Catheter placement was confirmed using contrast radiography. The epidural catheter was advanced through the needle in a cephalad direction to the C3–C5 level. Continuous cervical epidural block was performed with a midline approach at the C7–T1 or T1–T2 intervertebral space with the patient in the prone position. Records from 28 patients with a history of unsuccessful medical and invasive treatments for hiccups were evaluated. This study aimed to evaluate the effectiveness of continuous cervical epidural block in the treatment of intractable hiccups. Despite these potentially fatal complications, the etiology of intractable hiccups and definitive treatment are unknown. Intractable hiccups, although rare, may result in severe morbidity, including sleep deprivation, poor food intake, respiratory muscle fatigue, aspiration pneumonia, and death. As the exact mechanism of hiccups is not yet known, regardless the level of epidural or the mixture of drugs used, and the incident of hiccups after epidural injection is not well-reported, we think that the etiology and the incident rate must be further evaluated. Persistent hiccups after epidural injection is a serious complication. We present a rare case of persistent hiccups after a cervical epidural steroid injection in a 60-year-old male patient with chronic pain due to disc protrusion in C3–C7. Our presented case report provides insight into the side effect of hiccups that can occur in association with cervical epidural analgesia, and will help inform anesthesiologist about this unpleasant complication. A few studies have reported on the physiological and pharmacological aspects of hiccups after epidural steroid injection and there have been some case reports published. Hiccup is a rare complication after a cervical epidural steroid injection used in the treatment of chronic pain. Unusual or unexpected effect of treatment Clinical Procedure: Cervical epidural steroid injection
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