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Epidural injections 

Epidural injections
Epidural injections

Keith Bush

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date: 12 June 2021

The epidural space forms a useful route whereby drugs that may influence the theca or surrounding tissues can be specifically delivered. Traditionally, epidural injections have been associated with childbirth and surgical procedures. However, the use of epidural injections in the management of spinal pain goes back to 1901, with the introduction of cocaine through the caudal hiatus at the base of the spine. Following this, the use of local anaesthetic and normal saline is documented, until the addition of corticosteroids in the 1950s. The safety and relatively low incidence of side-effects are also confirmed. However, with such widespread usage, the small incidence of side-effects has been magnified, reminding us to remain vigilant. The other serious complication of note is in relation to cervical transforaminal injections (dorsal root ganglion blocks), with dozens of neurological complications, including a few deaths, being reported. This, along with suggested precautions, is addressed in the chapter.

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