Acute Rhabdomyolysis Following Epidural Steroid İnjection: An unusual Complication in a Low Back Pain Patient

Abstract

ÖzetEpidural steroid enjeksiyonu kronik bel ağrısında yaygın kullanılan bir tedavidir. Epidural steroid enjeksiyonun en sık görülen komplikasyonu, dural yırtığın eşlik ettiği yada etmediği çoğunlukla geçici olan baş ağrısıdır. Gözlenen diğer komplikasyonlar arasında; intravasküler enjeksiyon, lokal hematom, kanama, bel ağrısında artış, yüzde flushing, vazovagal reaksiyonlar, bulantı ve ateş bildirilmiştir. Bu olgu sunumunda lumber radikülopatiye bağlı kronik bel ağrısı olan hastaya uygulanan epidural steroid enjeksiyonunu takiben gelişen akut rabdomiyolizi sunduk.Anahtar sözcükler: Epidural steroid enjeksiyonu; bel ağrısı; rabdomiyoliz; serum kreatin kinaz; serum miyoglobin. SummaryEpidural steroid injection is a very common intervention in the treatment of low back pain and sciatic symptoms. The most common complication for epidural steroid injection is transient headache with or without identifiable dural puncture. Other complications have also been reported, including intravascular entry, local hematoma, bleeding, increased back pain, facial flushing, vasovagal reactions, nausea, and fever. We report a case of rhabdomyolysis following epidural steroid injection for lumbar radiculopathy.

Rhabdomyolysis and Obstetric Correlates: Literature Perspectives for the Obstetric Anesthesiologist

“…Serum creatinine kinase value up to 20,123 U /L (26-140), serum myoglobin 2977 ng/ml (14-66). There was resolution of her symptoms and biomarkers after ten days with intravenous fluid therapy in an intensive care unit [10].…”

“…Medications (such as statins, fibrates, certain antipsychotics, selective serotonin reuptake inhibitors (SSRIs), diuretics) have been associated with their tendency to cause rhabdomyolysis including succinylcholine and inhalational anaesthetics [9]. Reference [10] reported a case of rhabdomyolysis with onset of symptoms an hour after epidural steroid (dexamethasone) administration to treat a chronic low back pain in a 47-year-old female. Serum creatinine kinase value up to 20,123 U /L (26-140), serum myoglobin 2977 ng/ml (14-66).…”