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Adrenal suppression following extradural steroids
Author(s) -
JACOBS S.,
PULLAN P. T.,
POTTER JULIA M.,
SHENFIELD G. M.
Publication year - 1983
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1983.tb12025.x
Subject(s) - medicine , corticosteroid , adrenal cortex , methylprednisolone , endocrinology , lumbar , sciatica , aldosterone , steroid , anesthesia , hormone , surgery
Summary 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.