Flushing as a side effect following lumbar transforaminal epidural steroid injection.

BACKGROUND

Epidural steroid injections (ESI) are commonly used in managing radicular pain. The risk of complications with epidural steroids is small, with the majority of complications being non-specific. Flushing is a known side effect of corticosteroid administration. The occurrence of flushing after epidural steroids has not been studied prospectively.

OBJECTIVE

To compare flushing as a side effect of Betamethasone acetate/Betamethasone sodium phosphate (Celestone) vs. Methylprednisolone (DepoMedrol) in fluoroscopically guided epidural steroid injections.

STUDY

DESIGN

Non-concurrent Prospective Database Study

METHODS

Two-hundred forty patients, who underwent epidural steroid injections in the University of Rochester Spine Center in the year 2001 were included. Eighty-one patients underwent epidural steroid injections with Celestone. One hundred fifty nine patients received treatment with Depo-Medrol. Patients were contacted two days after the procedure by a staff member and specifically asked about the presence of flushing following steroid injection. The answers were recorded as "yes" or "no".

RESULTS

Out of 81 patients who underwent ESI with Betamethasone acetate/Betamethasone sodium phosphate, 13 reported a flushing reaction (16%). Out of 159 patients, who underwent ESI with Methylprednisolone, 14 reported a flushing reaction (9%). This side effect difference was not statistically significant (p < 0.143 and odds ratio of 0.505). The overall incidence of flushing was approximately 11%.

CONCLUSION

Flushing reaction appears to be more widespread than previously assumed, with an overall incidence of 11%. There was no significant difference in self-reported flushing reactions following lumbar epidural steroid injections using either betamethasone or methylprednisolone.