Dexmedetomidine for Transforaminal Epidural Injection for Lumbosacral Radicular Pain in Diabetes Mellitus Patients: A Case Series

BACKGROUND: Epidural steroid injection is challenging in patients with diabetes due to its associated complications including metabolic endocrine changes and osteoporosis. Dexmedetomidine is a highly selective alpha-2 agonist that has analgesic effects without affecting respiratory depression; its analgesic effect is achieved by on and above the spinal cord level. CASE REPORT: Under fluoroscopy-guided transforaminal injection of dexmedetomidine 50 µg with 0.2% ropivacaine, 2 mL were administered in 10 patients with diabetes mellitus. After the procedure, the Numeric Rating Scale score, Oswestry Disability Index, motor power, and sensory examination were assessed at one-week, one-month, and 3-month intervals. CONCLUSIONS: The use of dexmedetomidine for transforaminal injection in treating lumbosacral radicular pain appears to show encouraging results: it is feasible, safe, and associated with minimal adverse effects. KEY WORDS: Dexmedetomidine, lumbosacral radicular pain, neuropathic pain, neuroprotective