Will I be awake or sleeping during the procedure?

The procedure is performed under intravenous sedation unless you specifically request no sedation. Short-acting benzodiazepines (Versed) and opioids (Fentanyl) are given intravenously just before the procedure and as needed during the procedure for sedation and pain relief. The medicines are are designed to keep you comfortable and drowsy. At all times you will be conscious and responsive, yet relaxed and comfortable.

Preparing For Your Procedure

1. Do NOT eat solids for 6 hours prior to your procedure or drink liquids 2 hours prior to your procedure. You may take a sip of water if you need to take medicine.
   
   
2. Take your usual medicines on the day of the procedure unless instructed otherwise by your doctor.
   
   
3. You cannot take aspirin (including baby aspirin) 2 weeks prior to the procedure. If you take aspirin for your heart or blood vessels as prescribed by your doctor, you will need a written note from your doctor saying it is ok to stop taking your aspirin.
   
   
4. You cannot take Plavix(clopidogrel) for 2 weeks prior to the procedure. You will need a written note from your doctor saying it is ok to stop taking your Plavix.
   
   
5. You cannot take anti-inflammatory medicines 3 days prior to the procedure. Examples of anti-inflammatory medicines are: Advil, ibproufen, edtodolac, indomethacin, naproxen, Aleve, Feldene, diclofenac, Mobic, and piroxicam. You do not need to quit taking Celebrex, Vioxx, or Bextra prior to the procedure. If you are unsure if any of your medicines are anti-inflammatory medicines, ask your doctor.
   
   
6. You cannot take herbal medicines, fish oil, or Vitamin E for 3 days prior to the procedure.
   
   
7. Call your family doctor for instructions if you take blood thinners such as heparin or coumadin(Warfarin). Your blood clotting times will need to be normalized prior to your procedure if you take blood thinners.
   
   
8. Call your family doctor for instructions if you take medicine for diabetes. This procedure may temporarily increase your blood sugar if you have diabetes.
   
   
9. If you have glaucoma, this procedure could worsen your glaucoma. Please discuss this with your eye doctor to see if this procedure is safe for you.
   
   
10. Before the procedure, tell us if you have any drug allergies or if you have had a reaction to X-ray dyes (contrast dyes), iodine, betadine, seafood, shellfish, latex or local anesthetics (numbing medicine).
    
    
11. Make sure someone is able to drive you home. You can NOT drive yourself home after receiving sedative medications.
    
    
12. Bring your pain medicines with you to the hospital when you come for your procedure. Make sure you have enough pain medicine for after the procedure. You may still need to take it after the procedure. The doctor who performs your injection will not give you a prescription for pain medicine to take home.
    
    
13. Bring the latest version of any MRI or CT scans if these were not performed at UW Hospital or Research Park Clinic. You are responsible for getting and bringing your films. If you do not bring these films with you on the day of your procedure, your procedure cannot be performed. If you have had any spine surgery in the past, you need to bring an MRI or CT scan that was obtained after your surgery. If are unsure where or when your MRI or CT scan was done, call your doctor. If your scan was done at UW Hospital or Research Park Clinic, you do not need to bring your films.
    
    
14. You must be healthy on the day of the procedure. You must be free of infection, not taking antibiotics for 2 weeks prior to the procedure, and without cold or flu symptoms for 2 weeks prior to the procedure. You also must not have any rashes for 2 weeks prior to the procedure. If you are feeling sick or have a cold prior to the procedure, call the procedure team to let us know. Please try to call 24 hours or more prior to the procedure.
    
    
15. Call Joyce at (608) 444-7421, Maureen at (608) 262-0350, or Cindy at (608) 265-1729 if you need to cancel your procedure or have any questions regarding your procedure.

Referral

In some cases an approved referral from your physician is required. We recommend insurance authorization before scheduling the procedure. The staff at APC will handle this, however an approved referral expedites this process.

Background Information

Provide any medical information such as allergies to antibiotics, drugs, contrast, latex, sea food, etc. Also, provide medical history of bleeding disorders, anticoagulation (coumadin/heparin), aspirin, ticlid, NSAIDs, diabetes, seizure disorders, need for prophylactic antibiotics (prosthetic implants/artificial valves), pregnancy, breast feeding, HIV, hepatitis C.

What to expect on the day of the procedure?

You will be escorted to a pre-procedure prep area. Before the injection, you will change into a hospital gown and an IV will be started in your arm. You will be asked many questions about your medical history, current health, and current medications. You will also fill out a pain diagram. A healthcare provider will go over a procedure consent form with you. The purpose of the procedure, brief description of the procedure, and potential complications will be explained to you. If you have any questions, they will be answered at this time. Your family and friends can be with you before and after the procedure. No family members or friends are allowed into the procedure room.

The test/procedure is performed in an operating room equipped with an X-ray machine. A sedative medication will be given through the IV to make the procedure as easy as possible. However, you will remain awake throughout the test/procedure.

You will lie on the procedure table. You will be on your stomach for low back injections and on your side for neck injections. We will monitor your blood pressure, heart rate, and oxygen saturation throughout the procedure. We will use pillows to help position you and make you comfortable. The area to be injected will be thoroughly cleaned. Then, your neck or back will be covered with a sterile drape. Using the X-ray machine, your doctor will carefully guide a thin needle into your back or neck near the spine. The exact position depends on the type of injection. Your doctor will inject some X-ray (contrast) dye through the needle to verify the correct position of the needle. X-rays will be taken. Then local anesthetic (numbing medicine) and steroids (anti-inflammatory medicine) will be injected. During the procedure, you will be asked to lie very still and minimize talking. The procedure usually takes 30 to 45 minutes.

Post Procedure

When the procedure is complete, you will go to the recovery room where nurses and your doctor will monitor you for 30 to 60 minutes. You will be asked how much pain you are having and the location of the pain. The recovery room staff will make sure you have something to eat and drink. Before you go home, you will be examined briefly to make sure you are doing ok.

You will be given a pain log to complete for the next 14 days. This will let us know if and how much your pain was decreased. If you do not fill out and send back your pain log, we cannot do more procedures on you.

A Health Facts for You sheet will be given to you before you leave. It will explain what to expect following your injection and what to do if you have questions or concerns about the injection.

Your driver will take you home. You may not drive for 24 hours after receiving sedative medications.

UWIPP - First published: 02/14/03 Last updated: 10/06/08 webmaster@surgery.wisc.edu
Copyright © 2004 The Board of Regents of the University of Wisconsin System