Interlaminar cervical epidural injections of steroids plus local anesthetics in patients with cervical radiculopathy

Mohammed Samy Sharaf, Foad Ibrahim Ibrahim, Medhat Noeman, Adel Diab
Department of Anesthesia, Faculty of Medicine, Al-Azhar University, Damietta, Egypt

Correspondence Address:
Mohammed Samy Sharaf
Department of Anesthesia, Faculty of Medicine, Al-Azhar University, Damietta
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.7123/01.ASJA.0000415415.12216.0e

Transforaminal epidural injections have the advantage that medication can be placed directly around the dorsal root ganglion pathologically involved in causing a patient radicular pain. Medication in the epidural space will tend to flow in the direction of least resistance. With interlaminar paramedian cervical epidural injections, the medication tends to spread unilaterally in 51% and ventrally in only 28%.

Forty patients received a cervical epidural injection after the failure of conservative treatment. They were divided into two equal groups: the first group included 20 patients who received cervical epidural injections using a combination of corticosteroids and local anesthetic (dose: 1.0 ml of 1% lidocaine with 2.0 ml of dexamethsone 4 mg/ml for a total volume of 3.0 ml). The second group included 20 patients who received cervical epidural injections using only a local anesthetic (dose: 1.0 ml of 1% lidocaine with 2.0 ml normal saline to increase the total volume to 3 ml).

There was a statistically significant increase in the visual analog scale (after–before) in group A in comparison with group B (5.49±0.82 vs. 3.65±1.18, respectively).

According to the results of the present study, using a single injection for the treatment of cervical radiculopathy presenting with radicular pain, the combination of steroids and local anesthetics did provide more symptom reduction than the local anesthetics.