A justified controversy about epidural particulate steroids
Introduction: Epidural administration of steroids is a cornerstone for the treatment of cervical and lumbosacral radicular pain. Objective: To describe the physiological mechanisms and pharmacological characteristics of the corticosteroids used for pain treatment, as well as the complications deriv...
| Main Authors: | , , |
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| Format: | Article |
| Language: | Spanish |
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Centro Nacional de Información de Ciencias Médicas. Editorial de Ciencias Médicas (ECIMED)
2022-01-01
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| Series: | Revista Cubana de Anestesiología y Reanimación |
| Subjects: | |
| Online Access: | http://www.revanestesia.sld.cu/index.php/anestRean/article/view/717 |
| _version_ | 1818010105447186432 |
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| author | Antonio Ismael Aparicio Morales Alexis Ramón Pineda González Yaima Rizo Fiallo |
| author_facet | Antonio Ismael Aparicio Morales Alexis Ramón Pineda González Yaima Rizo Fiallo |
| author_sort | Antonio Ismael Aparicio Morales |
| collection | DOAJ |
| description | Introduction: Epidural administration of steroids is a cornerstone for the treatment of cervical and lumbosacral radicular pain.
Objective: To describe the physiological mechanisms and pharmacological characteristics of the corticosteroids used for pain treatment, as well as the complications derived from the epidural administration of particulate steroids.
Methods: A nonsystematic review of the literature was carried out, from July to September 2020, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID and the academic search engine Google Scholar.
Development: The corticoids used in pain medicine are derived from prednisolone. These are classified into particulate (deposit, suspension) or non-particulate (dilution), depending on the presence or absence of a solid molecular component (ester-type molecules, insoluble in water). The most commonly used drugs are dexamethasone, betamethasone, triamcinolone, and methylprednisolone.
Conclusions: The epidural administration of particulate steroids is related to the incidence of serious, although infrequent, complications, such as paraplegia, tetraplegia, spinal cord infarction, hemorrhage and cerebral edema. Available evidence shows analgesic effectiveness similar to that of non-particulate compounds. Therefore, its routine usage is not recommended during the managment of the epidural space.
Keywords: steroids; corticoids; particulate steroids; non-particulate steroids; epidural. |
| first_indexed | 2024-04-14T05:51:10Z |
| format | Article |
| id | doaj.art-1c8f51c3a19243d8be5a03eccd2fa440 |
| institution | Directory Open Access Journal |
| issn | 1726-6718 |
| language | Spanish |
| last_indexed | 2024-04-14T05:51:10Z |
| publishDate | 2022-01-01 |
| publisher | Centro Nacional de Información de Ciencias Médicas. Editorial de Ciencias Médicas (ECIMED) |
| record_format | Article |
| series | Revista Cubana de Anestesiología y Reanimación |
| spelling | doaj.art-1c8f51c3a19243d8be5a03eccd2fa4402022-12-22T02:09:07ZspaCentro Nacional de Información de Ciencias Médicas. Editorial de Ciencias Médicas (ECIMED)Revista Cubana de Anestesiología y Reanimación1726-67182022-01-01203606A justified controversy about epidural particulate steroidsAntonio Ismael Aparicio Morales0Alexis Ramón Pineda González1Yaima Rizo Fiallo2Complejo Científico Ortopédico Internacional Frank PaísHospital Pediátrico José Luis Miranda. Villa ClaraComplejo Científico Ortopédico Internacional Frank PaísIntroduction: Epidural administration of steroids is a cornerstone for the treatment of cervical and lumbosacral radicular pain. Objective: To describe the physiological mechanisms and pharmacological characteristics of the corticosteroids used for pain treatment, as well as the complications derived from the epidural administration of particulate steroids. Methods: A nonsystematic review of the literature was carried out, from July to September 2020, in scientific databases such as Cochrane Database of Systematic Reviews, Pubmed/Medline, EMBASE, Scopus, Web of Science, EBSCOhost, ScienceDirect, OVID and the academic search engine Google Scholar. Development: The corticoids used in pain medicine are derived from prednisolone. These are classified into particulate (deposit, suspension) or non-particulate (dilution), depending on the presence or absence of a solid molecular component (ester-type molecules, insoluble in water). The most commonly used drugs are dexamethasone, betamethasone, triamcinolone, and methylprednisolone. Conclusions: The epidural administration of particulate steroids is related to the incidence of serious, although infrequent, complications, such as paraplegia, tetraplegia, spinal cord infarction, hemorrhage and cerebral edema. Available evidence shows analgesic effectiveness similar to that of non-particulate compounds. Therefore, its routine usage is not recommended during the managment of the epidural space. Keywords: steroids; corticoids; particulate steroids; non-particulate steroids; epidural.http://www.revanestesia.sld.cu/index.php/anestRean/article/view/717esteroides, corticoides, esteroides particulados, esteroides no particulados, epidural |
| spellingShingle | Antonio Ismael Aparicio Morales Alexis Ramón Pineda González Yaima Rizo Fiallo A justified controversy about epidural particulate steroids Revista Cubana de Anestesiología y Reanimación esteroides, corticoides, esteroides particulados, esteroides no particulados, epidural |
| title | A justified controversy about epidural particulate steroids |
| title_full | A justified controversy about epidural particulate steroids |
| title_fullStr | A justified controversy about epidural particulate steroids |
| title_full_unstemmed | A justified controversy about epidural particulate steroids |
| title_short | A justified controversy about epidural particulate steroids |
| title_sort | justified controversy about epidural particulate steroids |
| topic | esteroides, corticoides, esteroides particulados, esteroides no particulados, epidural |
| url | http://www.revanestesia.sld.cu/index.php/anestRean/article/view/717 |
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