The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.
The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
As a skilled and experienced Pain Medicine Interventionalist, Dr. Levin evaluates each patient very thoroughly and carefully to help determine appropriate treatment options in order to provide the most effective individualized care. These treatment options may include: Lumbar, Thoracic and Cervical Epidural Steroid Injections utilizing targeted transforaminal techniques, Lumbar and Cervical Sympathetic Blocks, Sphenopalatine, Facial and Head and Neck Procedures, Discography, Percutaneuos Discectomy or Disc Decompression procedures, precision joint and nerve injections, Radiofrequency Neuroablative procedures, Peripheral or Spinal Cord Stimulator trials and implants, Foraminoplasties and several patented and patent pending advanced interventional procedures.