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Medications used in Spinal Injection Procedures
Not every medicine is used for all procedures. Medications given IV
for sedation are optional for most procedures.
- Fentanyl is an opioid type pain medicine used during
procedures for pain analgesia and sedation. Fentanyl decreases pain
and may cause drowsiness. It is given through the IV. It acts quickly,
with effects often felt in less than one minute. It is completely
cleared from the body in 30 minutes to 1 hour. It is less likely to
cause nausea than Demerol or morphine. The effects of fentanyl can
be reversed with naloxone. If you have severe allergy to morphine,
Demerol, Vicodin, Percocet, Dilaudid, or other pain medicines, please
tell your healthcare provider prior to any procedures. Fentanyl is
the active ingredient in Duragesic patches and Actiq lozenges.
- Versed (midazolam) is a benzodiazepine-type sedative
medicine used during procedures for sedation. It also decreases anxiety.
It is given through the IV. Midazolam may cause short-term amnesia
and memory impairment, which may cause you to forget most of the procedure.
The effect of midazolam can be felt in 1-5 minutes. Midazolam is completely
cleared from the body in 30-80 minutes, but you should not drive for
24 hours after receiving midazolam because it can slow your reaction
time. The effect of midazolam can be increased in patients who take
opioid pain medicines. Midazolam should not be used in patients who
are pregnant or who have acute angle closure glaucoma. The effects
of midazolam can be reversed with flumazenil. If you have severe allergy
to valium or other anti-anxiety or sleep medicines, please tell your
healthcare provider prior to any procedures. If you have glaucoma,
please check with your healthcare provider to see if this procedure
is safe for you.
- Omnipaque 240 (iohexol) is nonionic iodinated
contrast dye used during procedures to see needle position. It shows
up on x-ray and CT scan for 30-60 minutes, and is completely cleared
from the body in several hours. Usually you experience no symptoms
from receiving Omnipaque. It contains iodine. If you are allergic
to iodine, shellfish, or other contrast dye, please tell your healthcare
provider prior to any procedures.
- Lidocaine (1%, preservative free) is a local anesthetic
used for numbing during procedures. During spinal injection procedures,
it is injected into the skin around the injection site and also into
the area being injected. The effects are felt in less than 1 minute.
The numbing effect lasts less than 2 hours. Even while the lidocaine
is working, you still may be able to feel hot/cold and pressure, but
sharp pain will be decreased. If you are allergic to lidocaine or
any other local anesthetics, please tell your healthcare provider
prior to any procedures.
- Bupivucaine (0.25%, 0.5%) is a local anesthetic
used for numbing. During spinal injection procedures, it is used at
the injection site. The effects are felt in 30-45 minutes and last
3-6 hours. You may experience loss of sensation and weakness in the
affected area. If you are allergic to bupivucaine or any other local
anesthetics, please tell your healthcare provider prior to any procedures.
- Celestone(betamethasone) is a steroid medicine
used to decrease irritation and inflammation. During spinal injection
procedures, it is used at the injection site. The effects are not
felt for 2-3 days, and the effects may last from a few days to several
months. Celestone may cause a temporary increase in pain for several
days. This is called a steroid flare. The anti-inflammatory effect
of Celestone may be increased in patients with hypothyroidism or cirrhosis.
If you are diabetic, Celestone may temporarily increase your blood
sugars. Other side effects from Celestone are very rare, as the medicine
does not spread throughout the whole body. If you are allergic to
Celestone or any other steroid medication, please tell your healthcare
provider prior to any procedure.
- Depo-Medrol (methylprednisolone acetate) is a
steroid medicine used to decrease irritation and inflammation. It
is only used for interlaminar epidural steroid injections. It is used
at the injection site. The effects are not felt for 2-3 days, and
the effects may last from a few days to several months. Administration
of Depo-Medrol may cause a temporary increase in pain for several
days. The anti-inflammatory effect of Depo-Medrol may be increased
in patients with hypothyroidism or cirrhosis. If you are diabetic,
Depo-Medrol may temporarily increase your blood sugars. Other side
effects from Depo-Medrol are very rare, as most of the medicine does
not spread throughout the whole body. If you are allergic to Depo-Medrol
or any other steroid medication, please tell your healthcare provider
prior to any procedure.
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