In one patient, the drug was changed from 80 mg triamcinolone to 120 mg Depomedrol Registered Trademark (methylprednisolone Lederle Parenterals Inc., Carolina, Puerto Rico). Of these 10 patients, 9 received either 80 mg or 120 mg of triamcinolone. Ten patients received a second injection. The patient who had no adverse reaction to the first injection developed a red face and a warm feeling after a subsequent injection of 80 mg triamcinolone approximately 1 mo later. All patients except one developed facial flushing or erythema after the initial injection. In every patient, either 80 mg or 120 mg of Aristocort Registered Trademark (triamcinolone diacetate Fujisawa Pharmaceutical Co., Deerfield, IL) was given for the initial epidural injection. Ten patients underwent lumbar epidural steroid injection and two patients had a series of cervical epidural steroid injections. The eight remaining patients had no known drug allergies.

Of these 12 patients, only one had a known sensitivity to aspirin, while three patients had documented allergies to sulfa drugs. No systemic manifestations occurred during any of these reactions to indicate an anaphylactic event.

Other patients experienced erythema primarily limited to the trunk and extremities although three patients developed cutaneous reactions involving the face, trunk, and extremities. The reactions were typically described as a 'sunburned' or a generalized reddish appearance of the skin which in some patients was present only on the face. During that time we encountered 12 patients who developed facial flushing and/or generalized erythema after epidural steroid administration. Of those injections, 1021 were performed at the lumbar level whereas the remaining 378 were cervical epidural injections. Case Reportīetween August 1, 1990, and August 13, 1993, we performed 1399 epidural steroid injections for patients with chronic radicular pain. We describe a series of 12 patients each of whom developed facial flushing and/or generalized erythema after receiving an epidural steroid injection for lumbar or cervical radiculopathy. As the indications for epidural steroid injections increase so do the reports of adverse responses associated with this procedure.

Epidural steroid injections have become one of the most frequently used conservative options in the management of acute and chronic back pain.

Epidural after effects