LESI LESI Pharmacology

Question 1

Which corticosteroid is particulate and therefore associated with higher risk of embolic complications in transforaminal LESI?

Accepted Answer

Methylprednisolone acetate (Depo-Medrol)

Answer

Methylprednisolone acetate is a particulate steroid; its particles can aggregate and cause embolic occlusion of spinal arteries if inadvertently injected intravascularly.

Question 2

Which corticosteroid is recommended as the preferred agent for transforaminal LESI because it is non-particulate?

Accepted Answer

Dexamethasone

Answer

Dexamethasone is a non-particulate steroid that does not form aggregates, making it the preferred and safer choice for transforaminal injections.

Question 3

What is the primary mechanism by which corticosteroids reduce radicular pain in LESI?

Accepted Answer

Inhibition of phospholipase A2 and reduction of inflammatory mediators

Answer

Corticosteroids reduce inflammation by inhibiting phospholipase A2, thereby decreasing prostaglandins, leukotrienes, and other inflammatory mediators around compressed nerve roots.

Question 4

The local anesthetic most commonly added to corticosteroids in LESI to provide immediate pain relief is:

Accepted Answer

Bupivacaine 0.25% or lidocaine 1%

Answer

Bupivacaine (0.25%) or lidocaine (1%) are the most commonly used local anesthetics combined with corticosteroids to provide immediate but temporary pain relief during LESI.

Question 5

The typical dose of triamcinolone acetonide used per interlaminar LESI is:

Accepted Answer

20-40 mg

Answer

Triamcinolone acetonide is typically used at 20-40 mg per lumbar epidural steroid injection, balancing efficacy with minimizing systemic steroid effects.

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI - Lumbar Epidural Steroid Injection Practice Test

LESI LESI Pharmacology