Bicket Mark C, Chakravarthy Krishnan, Chang David, Cohen Steven P
Department of Anesthesiology, Critical Care & Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
Pain Manag. 2015;5(2):129-46. doi: 10.2217/pmt.14.53.
Epidural steroid injections (ESIs), which can provide significant but temporary pain relief in well-selected patients, are the most commonly performed procedure in pain management. The anatomy of the epidural space provides a framework for understanding risks associated with ESIs, a topic relevant to both patients and physicians in interventional pain, surgery and primary care. Safety considerations of epidural steroids include drug preparation and myriad physiological effects stemming from steroid exposure. Although major complications associated with ESI occur rarely, potentially catastrophic events resulting from infectious, hematologic and neurologic morbidity may lead to permanent injury. The safety profile of ESIs may improve with development and dissemination of sound injection technique, safer compounds manufactured in a sterile manner and deficient of thromboembolic potential and the application of existing technology.
硬膜外类固醇注射（ESIs）在精心挑选的患者中可提供显著但短暂的疼痛缓解，是疼痛管理中最常进行的操作。硬膜外间隙的解剖结构为理解与ESIs相关的风险提供了一个框架，这一主题对介入性疼痛、外科手术和初级保健中的患者及医生均相关。硬膜外类固醇的安全考虑包括药物制备以及类固醇暴露所产生的众多生理效应。虽然与ESI相关的主要并发症很少发生，但由感染、血液学和神经学发病导致的潜在灾难性事件可能会导致永久性损伤。随着合理注射技术的发展与传播、以无菌方式生产且缺乏血栓栓塞潜能的更安全化合物的出现以及现有技术的应用，ESIs的安全性可能会得到改善。
