The Change of Blood Glucose and Cortisol Levels after Three Consecutive Epidural Steroid Injections

ABSTRACT

OBJECTIVE: To investigate the change of blood glucose and cortisol levels after three consecutive epidural steroid injections METHOD: Fifteen patients with low back pain and radiating pain were included. Three consecutive epidural injections were performed weekly. The serum glucose, insulin and cortisol levels were measured 30 minutes before the 1st injection and at 24 hours and l week after each injection. RESULTS: There were significant changes in the result of glucose and insulin levels at 24 hours after each injection (p<0.05), but no signigicant changes at 1 week compared with pre-injection level. The cortisol level significantly decreased at 24 hours after 1st injection and did not return to pre-injection level at 1 week after 1st injection (p<0.05). There were no further increases in the glucose and insulin levels and no further decrease in the cortisol level after each of the three consecutive injections. CONCLUSION: Three consecutive epidural injections at 1 week interval seems to be as safe procedure. But significant suppression of cortisol kept on for 1 week, so it should be taken into account when patients with previous epidural injection undergo major stress.