Particulate be non-particulate steroids

[SommeRiver]

Depo > Dex

It lasts longer and your pts will hug you at the follow up, and that visit will result in a "come back PRN."

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[MD87]

Anesthesiology

pubs.asahq.org

I did see this article. 14 years old. Wondering if anyone has clinical experience with it (anecdotal is fine).

 

[xvaderx]

I started doing some injections at a new location the other month. I always use beta for ILESI, and as I'm drawing it up, I notice it's clear. I double checked the bottle. Apparently it's betamethasone sodium phosphate, not betamethasone sodium phosphate/betamethasone acetate. Any experience with this? Didn't even know it existed.

I don't have experience with that in particular but check the label to make sure it's actually preservative free.. . .

I have betamethasone, dexamethasone, triamcinolone and depo bottles all in front of me right now, guess which one says its for epidural use?

The company won't even put it on the bottle, we have our fellow doctors actually advertising to eviscerate us. . . .

Furthermore, have you noticed ASIPP is starting a local anesthetic only push. . . .

I like beta myself (smallest particles, mostly fluid, not associated with catastrophes last I checked), but the times are a changin'

 

[NJPAIN]

Anesthesiology

pubs.asahq.org

Celestone is a mix of the two as you indicate. Off of the top of my head I think that I recall that beta sodium phosphate is more immediate in onset and shorter acting.
I recall that one compounding pharmacy, the infamous New England Compounding, was selling it as BetaCLEAR.

 

[bedrock]

Betamethasone has some clinical advantages in that it works more quickly, but disadvantages in that it is still particulate. You're kidding yourself if you think it is safe to do a L3-L4 TFESI with celestone. Dex is far safer, though it doesn't last as long.

 

[SommeRiver]

...just don't mix ropi with dex.

 

[clubdeac]

...just don't mix ropi with dex.

why? educate me

 

[SommeRiver]

why? educate me

Pretty sure dex and ropi crystallize.

 

[Ducttape]

the issue is that ropivicaine can crystalize in an alkaline solution, of which most dexamethasone is.

cant use sodium bicarb with it.

however, there are several studies that have used the combination of the 2 and no documentation in those studies of complications.

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