The patient is placed prone (lying face down) with two pillows under the chest and a small pillow under the forehead. The appropriate region of the skin is sterilely prepared. Using fluoroscopic (x-ray) guidance, the appropriate path for the needle is determined. The skin is anesthetized and a thin needle is advanced to the appropriate region. A small volume of contrast solution is injected to show that the medication will flow exactly where intended. Then a small volume of anesthetic, along with steroid (usually betamethasone), is injected. The patient is cared for in the recovery area for 20-30 minutes.
It is typically done with you lying on your stomach. Your blood pressure and oxygen levels will be monitored. In addition to your doctor and the x-ray technician, there will be a nurse in the room at all times. The skin on the back is cleaned with antiseptic solution. A separate area where a good vein is available is also cleaned with antiseptic solution. A small intravenous catheter is placed in the vein. After your doctor has placed the epidural needle near the affected area, he will draw about 20-25 cc of blood from your vein and will then gradually inject the blood.
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.