Sedation for epidural steroid injections

This is awful,and you need to understand that it’s not you. My belief from what you described is there is real damage to you cord, muscles, and nerves at the location. I personally went in for a C4-5 bone graft, and was woke with a C4,5,6,7 cage installation, 2 different neck cuts to access the site, and in pain as if the surgery was still being 4th day of refusing to leave,unable too. On 5th day I was able to stand and walk loaded with alot of IV pain discharged me that evening, 9 days later I barely made it in for visit,4 weeks later i found myself being dismissed when unable to walk, speak, lose control of my urine. In short it was the beginning of nothing else I can do, to i won’t see you again, and had me removed using the police. This was back in Dec3,2013, now I’ve got narrowing of the spinal cord at every level of the c2,3,4,7, now same at the L1,2,3,4,and S1. Since this I’ve been provoked to no pain meds, always u need pain pump,i injections, and suffering until insane. If I had the chance to go back in time, I’d went to assisted living where they had to manage the pain, and rest until I got better. In short I went to Florida, done nothing but rest for 7 months before I got to this point of variable pain. They are slow killing is, and don’t care what you go through as they dont even remember you doctor visits. It was hard to except. My point is, Everytime I listen to them instead of my body, I was just a pitiful mess. You need to get with the best spine people and pray they can fix it, but don’t worry about getting back to normal or even the simplistic things as it will take you back to hell and it takes longer Everytime you have flare it up. I laid like a vegetable for 18 months before I figured it out. Now I’m in bad shape and they are offering only injections, I’m thinking really hard, shame they are not made to get you better. This is what’s going on with society today, they’ll have to answer one day. But you make sure your not stubborn like I was and demand treatment it takes and the proper care. I’m praying for you, and I hope we get this country on the right track again as well as the compassion for others comes back

Postoperative pain relief was studied in 280 patients undergoing various kinds of surgery, ., thoracic, upper and lower abdominal, perineal, obstetric, and orthopedic. Morphine, 2 or 4 mg, was given after surgery through an indwelling epidural catheter. Excellent analgesia was noted in 87% of patients; only % of patients were dissatisfied. A single injection gave complete pain relief for the entire postoperative period in 30% of cases; in the remaining patients the mean duration of analgesia was hours (SD +/- ). Plasma morphine concentrations recorded after 2-mg doses suggest a regional spinal action as the basis for the long duration of analgesia, although the initial effect after 4-mg doses might well include systemic responses due to rapid vascular uptake of morphine from the epidural space. Peak expiratory flow (PEF) measurements and arterial blood gas analyses showed no significant early postoperative respiratory depression. Absence of sedation, orthostatic hypotension, respiratory depression, and motor paralysis facilitated early ambulation with less risk for postoperative respiratory complications. It is concluded that 2-mg doses of epidural morphine give good analgesia of long duration despite low plasma levels. After upper abdominal and thoracic surgery higher doses (4 mg) may be necessary in healthy patients. Elderly and frail patients appear to be sensitive to epidural morphine and doses in excess of 2 mg should be avoided regardless of the type of surgery. With this dose schedule we have not encountered delayed respiratory depression.

The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.

As with all potent µ-agonist opiates, tolerance as well as psychological and physical dependence to morphine may develop irrespective of the route of administration ( intravenous , intramuscular , intrathecal, epidural or oral). Tolerance is a condition in which previous exposure to an opiate results in the necessity for increasingly larger doses of the drug in order to produce the same degree of analgesia. Withdrawal symptoms , indicating the presence of psychophysiological dependence, may occur when morphine is discontinued abruptly after chronic administration for analgesia, or upon administration of a drug with full or partial opiate antagonist effects. Care must be taken to avert withdrawal in patients who have been maintained on parenteral/oral opiates prior to epidural administration of DepoDur (morphine sulfate xr liposome injection) .

Sedation for epidural steroid injections

sedation for epidural steroid injections

As with all potent µ-agonist opiates, tolerance as well as psychological and physical dependence to morphine may develop irrespective of the route of administration ( intravenous , intramuscular , intrathecal, epidural or oral). Tolerance is a condition in which previous exposure to an opiate results in the necessity for increasingly larger doses of the drug in order to produce the same degree of analgesia. Withdrawal symptoms , indicating the presence of psychophysiological dependence, may occur when morphine is discontinued abruptly after chronic administration for analgesia, or upon administration of a drug with full or partial opiate antagonist effects. Care must be taken to avert withdrawal in patients who have been maintained on parenteral/oral opiates prior to epidural administration of DepoDur (morphine sulfate xr liposome injection) .

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