• Clifford R Everett, Michael N Baskin, David Speech, Dmitry Novoseletsky, and Rajeev Patel.
• Department of Orthopaedics and Physical Medicine, University of Rochester Spine Center, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 65, Rochester, New York 14642, USA. clifford_everett@URMC.Rochester.edu
• Pain Physician. 2004 Oct 1;7(4):427-9.

BackgroundEpidural steroid injections (ESI) are commonly used in managing radicular pain. The risk of complications with epidural steroids is small, with the majority of complications being non-specific. Flushing is a known side effect of corticosteroid administration. The occurrence of flushing after epidural steroids has not been studied prospectively.ObjectiveTo compare flushing as a side effect of Betamethasone acetate/Betamethasone sodium phosphate (Celestone) vs. Methylprednisolone (DepoMedrol) in fluoroscopically guided epidural steroid injections.Study DesignNon-concurrent Prospective Database StudyMethodsTwo-hundred forty patients, who underwent epidural steroid injections in the University of Rochester Spine Center in the year 2001 were included. Eighty-one patients underwent epidural steroid injections with Celestone. One hundred fifty nine patients received treatment with Depo-Medrol. Patients were contacted two days after the procedure by a staff member and specifically asked about the presence of flushing following steroid injection. The answers were recorded as "yes" or "no".ResultsOut of 81 patients who underwent ESI with Betamethasone acetate/Betamethasone sodium phosphate, 13 reported a flushing reaction (16%). Out of 159 patients, who underwent ESI with Methylprednisolone, 14 reported a flushing reaction (9%). This side effect difference was not statistically significant (p < 0.143 and odds ratio of 0.505). The overall incidence of flushing was approximately 11%.ConclusionFlushing reaction appears to be more widespread than previously assumed, with an overall incidence of 11%. There was no significant difference in self-reported flushing reactions following lumbar epidural steroid injections using either betamethasone or methylprednisolone.

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