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 & respiratory depression; the patient should have no clear liquids | <i>1. Sedation:</i> risk of aspiration & 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 | <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 < 3g minimizes toxicity; | ||
<br/> | <br/> | ||
<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 | <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. | ||
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.
