I have received my information packet for the procedure scheduled with dr

I have received my information packet for the procedure scheduled with Dr. Bernaiche labeled CERVICAL EPIDURAL STEROID INJECTION. 2. Medication list of general blood thinning (anticoagulant) medications. General Information Sheet
CERVICAL (NECK) EPIDURAL INJECTION AS SCHEDULED WITH DR.
BERNAICHE

What is it?

A block/injection that is performed under fluoroscopy to confirm a specific diagnosis and/or decrease pain and inflammation.
What is the epidural space?

The membrane that covers the spinal cord and nerve roots in the spine is called the dural membrane. The space surrounding the dura is the epidural space. Nerves travel
through the epidural space to the neck and into the arms. Inflammation of these nerve
roots may cause pain in these regions due to irritation from a damaged disc or from
contract in some way with the bony structure of the spine.

What is an epidural and why is it helpful?

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the neck or
arms. The epidural injection may help the injury to heal by reducing inflammation. It
may provide permanent relief or provide a period of temporary pain relief for a variable
number of days to several months while the injury/cause of pain is healing.
What happens during the procedure?

The patient is placed lying on their stomach on the x-ray table and positioned in such a way that the physician can best visualize the upper back and neck using x-ray guidance. The skin on the neck is scrubbed using 2-3 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into the epidural space. A small amount of contrast (dye) is injected to insure the needle is properly positioned in the epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.
How long does it take?

The actual procedure takes only a few minutes (5 to 10 mins).
What happens after the procedure?

Patients are then returned to the recovery area where they are monitored for 10-20 minutes. Patients are then asked to record the relief they experience during the next week on a post injection evaluation sheet (“pain diary”). This will be given to the patient when they are discharged home. A follow-up appointment will be made for a repeat block if indicated. The neck or arms may feel weak or numb for a few hours. This is to be xpected, however it does not always happen. e
General Pre/Post Instructions
Patients can eat a light meal (soup/ toast) no sooner than 4 hours before the procedure. Stop drinking any liquid 2 hours before the procedure. If a patient is an insulin dependent diabetic, they must not change their normal eating pattern prior to the procedure (however they should tell the nurse and doctor so). Patients may take their routine medications the day of the procedure no sooner than 4 hours before the procedure Patients should not take pain medications or anti-inflammatory medications the day of their procedure. Patients have to be able to tell the difference between the injection effect and the effect of pain medicine and thus should have some of their usual pain symptoms prior to this procedure. They may not take medications that may give pain relief or lessen their usual pain. These medicines can be restarted after the procedure if they are needed. If a patient is on Coumadin (blood thinner) or Glucophage (a diabetic medicine) they must notify the office so the timing of these medications can be explained. Generally all blood thinners are STOPPED 5-7 days before the injection. Summary: -Stop drinking 2 hours before the procedure -Take all regular medications on the medications you take including strength After the procedure you will spend some time in the recovery area. This varies from person to person. You may notice some changes with the body. These can be explained by the docto edical team will assist you with you care.
Complications

Complications are rare but may include headaches, infections, blood pressure changes, bleeding, and discomfort at needle insertion site. Use of steroids rarely causes and blood pressure, as well as flushing. The major complication, that being damage to a nerve is very rare. Our attention to all the aspects
of care limits these risks and complications as much as possible.
When to call your doctor

-Severe pain or headache after the first 24 hours, not relieved by medication.
-Fever or chills 24 hours after the procedure. -Redness or swelling around the injection site. “BLOOD TH
Medications that are considered blood thinners, these should be stoppe o your in ction, as requested by Dr. Bernaiche Advil Migraine
Athtotec
Azulfidine
Angiomax
Celebrex
Combinox
Disalisid
Excedrin Migraine
Fiorinal
Indometh cin
Integrel
Ketoralac
Motrin IB
Naprosyn
Prevacid Naprapac
Persantine
Refludan
Tolmetin
Trisilate
Voltaren
Vicoprofen
Vitamin E
Warfarin
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Source: http://www.hampshireorthopedics.com/forms/pi_infoCERVICAL%20EPIDURAL%20STEROID%20INJECTION.pdf