Difference between revisions of "SPINE INJECTION-PROCEDURAL RISK"

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===== [[Summary Article|'''SUMMARY''']] =====
===== [[Summary Article|'''SUMMARY''']] =====
<i>1. Sedation:</i> risk of aspiration &amp; respiratory depression; the patient should have no clear liquids for 2 hrs and no solids for 6 hrs before the procedure.
<i>1. Sedation:</i> risk of aspiration &amp; respiratory depression; the patient should have no clear liquids for 2 hrs and no solids for 6 hrs before the procedure.
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<br/><i>2. Contrast agents:</i> using the lowest possible dose of the <i>nonionic form</i> of contrast helps to minimize the risk of developing renal toxicity; keeping the iodine dose &lt; 3g minimizes toxicity;  
<br/><i>2. Contrast agents:</i> using the lowest possible dose of the <i>nonionic form</i> of contrast helps to minimize the risk of developing renal toxicity; keeping the iodine dose &lt; 3g minimizes toxicity;  
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<br/><i>3. Gadolinium:</i> can substitute iodinated contrast and has less toxicity.
<br/><i>3. Gadolinium:</i> can substitute iodinated contrast and has less toxicity.
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<br/><i>4. Metformin:</i> Metformin can increase the risk of renal toxicity and precipitate severe lactic acidosis in diabetic patients, withhold it after the use of iodinated contrast.
<br/><i>4. Metformin:</i> Metformin can increase the risk of renal toxicity and precipitate severe lactic acidosis in diabetic patients, withhold it after the use of iodinated contrast.
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<br/><i>5. Nephrotoxic meds: </i>combining contrast with nephrotoxic meds increases risk of renal toxicity.
<br/><i>5. Nephrotoxic meds: </i>combining contrast with nephrotoxic meds increases risk of renal toxicity.
==Reference(s)==
Furman, Michael B., and Leland Berkwits. Atlas of Image-Guided Spinal Procedures. Elsevier, Inc, 2017.
<br/>Horowitz AL. MRI Physics for Physicians. Springer Science & Business Media. (1989) ISBN:1468403338.
<br/>Mangrum W, Christianson K, Duncan S et-al. Duke Review of MRI Principles. Mosby. (2012) ISBN:1455700843.


[[Category:Spine Injection]]
[[Category:Spine Injection]]
[[Category:Radiology]]
[[Category:Radiology]]
[[Category:Radiology]]
[[Category:Radiology]]

Latest revision as of 09:55, 25 July 2023

SUMMARY

1. Sedation: risk of aspiration & respiratory depression; the patient should have no clear liquids for 2 hrs and no solids for 6 hrs before the procedure.

2. Contrast agents: using the lowest possible dose of the nonionic form of contrast helps to minimize the risk of developing renal toxicity; keeping the iodine dose < 3g minimizes toxicity;

3. Gadolinium: can substitute iodinated contrast and has less toxicity.

4. Metformin: Metformin can increase the risk of renal toxicity and precipitate severe lactic acidosis in diabetic patients, withhold it after the use of iodinated contrast.

5. Nephrotoxic meds: combining contrast with nephrotoxic meds increases risk of renal toxicity.


Reference(s)

Furman, Michael B., and Leland Berkwits. Atlas of Image-Guided Spinal Procedures. Elsevier, Inc, 2017.
Horowitz AL. MRI Physics for Physicians. Springer Science & Business Media. (1989) ISBN:1468403338.
Mangrum W, Christianson K, Duncan S et-al. Duke Review of MRI Principles. Mosby. (2012) ISBN:1455700843.