Adrenal suppression following extradural steroids

1365-2044

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Adrenocortical function was tested in 12 patients following a single lumbar extradural injection ofmethyl-prednisolone acetate (‘Depo-Medrol’) 80 mg as treatment for chronic sciatica. There was no absorption of the corticosteroid into the systemic circulation, but marked suppression of plasma Cortisol levels was documented for up to 3 weeks following the injection and the capacity of the adrenal cortex to secrete Cortisol in response to synthetic adrenocorticotrophin (ACTH) was diminished. These results suggest that the dose and frequency of extradural steroid administration should be kept to a minimum to prevent suppression of the hypothalamicjpituitaryladrenocortical axis and that patients thus treated should he considered candidates for steroid cover during surgery and other stressful procedures.

Electronic Resource