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The Use of Contrast Agents in Interventional Pain Procedures: A Multispecialty and Multisociety Practice Advisory on Nephrogenic Systemic Fibrosis, Gadolinium Deposition in the Brain, Encephalopathy After Unintentional Intrathecal Gadolinium Injection, and Hypersensitivity Reactions. Anesth Analg 2021 Aug 01;133(2):535-552

Date

03/24/2021

Pubmed ID

33755647

DOI

10.1213/ANE.0000000000005443

Scopus ID

2-s2.0-85109709234 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

This Practice Advisory presents a comprehensive and evidence-based set of position statements and recommendations for the use of contrast media in interventional pain procedures. The advisory was established by an international panel of experts under the auspices of 11 multinational and multispecialty organizations based on a comprehensive review of the literature up to December 31, 2019. The advisory discusses the risks of using gadolinium-based contrast agents. These include nephrogenic systemic fibrosis, gadolinium brain deposition/retention, and encephalopathy and death after an unintentional intrathecal gadolinium injection. The advisory provides recommendations on the selection of a specific gadolinium-based contrast agent in patients with renal insufficiency, those who had multiple gadolinium-enhanced magnetic resonance imaging examinations, and in cases of paraspinal injections. Additionally, recommendations are made for patients who have a history of mild, moderate, or severe hypersensitivity reactions to contrast medium.

Author List

Benzon HT, Maus TP, Kang HR, Provenzano DA, Bhatia A, Diehn F, Nelson A, McCormick ZL, Liu BP, de Andres Ares J, Anitescu M, Blackham K, Bhaskar A, Brill S, Collins J, Gulve A, Hurley RW, Jeon YH, Moon JY, Rauck RL, Rodes M, Lee RK, Shah V, Shanthanna H, van Zundert J, Huntoon M, Rathmell JP, Borges MS, Cohen SP, Greenberger PA

Author

Robert W. Hurley MD, PhD Adjunct Professor of Anesthesiology and CTSI in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Brain
Brain Diseases
Consensus
Contrast Media
Delphi Technique
Drug Hypersensitivity
Humans
Nephrogenic Fibrosing Dermopathy
Pain Management
Prognosis
Risk Assessment
Risk Factors
Tissue Distribution