SPINE INJECTION-ALLERGY RISK

SUMMARY

1. Allergy to contrast is more common and is usually an anaphylactoid type of reaction.

2. Allergy to topical iodine solutions is not an allergy to iodine, but to other agents within the solution.

3. Anaphylactic food allergies in general (including shellfish, fish, eggs, milk, and chocolate), however, do correlate with an increased risk of contrast allergy114.

HISTORY OF CONTRAST ALLERGY
4. If patients have a history of a contrast allergy, they can be premedicated with prednisone, 20 to 50 mg orally 6 hours prior to procedure.

5. Ranitidine, 50 mg orally 2 hrs precontrast, and diphenhydramine, 25-50 mg orally 2 hrs precontrast or IV 10 min precontrast, can also be helpful.

6. Use of gadolinium as an alternative contrast agent.

7. Anaesthesia: those with an allergy to esters are not usually allergic to amide anesthetics, and vice versa.

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.