INSTRUCTIONS FOR INJECTION PROCEDURE

• Our office staff will schedule the date of your injection procedure with the hospital.
• Our office staff will notify you of the date and time of your procedure/s.
• You will have to report at least 90 minutes (1 1/2 hours) prior to your scheduled time. Go directly to the ADMITTING OFFICE to register. Bring all insurance information with you.
• If you are on any of the following blood thinner medications (ASPIRIN, COUMADIN, PLAVIX, TRENTAL), you must stop taking them at least 10 days prior to your scheduled procedure day/s.
• Anti-Inflammatory Pain Medications (Naprosyn, Nuprin, Aleve, Excedrin, Motrin, Ibuprofen, Trilisate, Cataflam, etc) and Vitamin E must also be stopped 10 DAYS prior to your scheduled procedure. Celebrex/Vioxx/Bextra can be stopped 1 day before the procedure.
• No eating or drinking anything after midnight prior to your scheduled day for the procedure. You may take your daily medications with sips of water. If you are a diabetic and scheduled in the afternoon, you may have toast with no butter and/or coffee without milk or cream at least 6 hours prior to your procedure.
• If you are on COUMADIN, you will need to have a blood test on the day of the procedure arranged by the Admitting Office. Bring the order slip for this test given to you by the doctor.
• You may / may not be given light sedation during the procedure as discussed by the doctor. The recovery room staff will monitor you for at least one hour after the injection.
• You will not be able to drive yourself home. Please arrange for transportation.
• Please notify our office at least 24 hours if you decide to cancel your procedure or you will be charged a $30.00 cancellation fee.

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INSTRUCTIONS WHEN DISCHARGED HOME

• Rest for the remainder of the day; at most, only light activity at home.
• Do not drive or make any important decisions for the next 24 hours.
• Resume all your daily medications. If you are on COUMADIN, resume it on the next day.
• Ice the injections site for 15 minutes at home at least 3 times, repeated every hour.
• Remove the dressing on your injection site the next morning when you take a shower.
  

When to contact the doctor:

• Persistent headache, numbness in arms or legs
• Fever
• Excessive bleeding at the site of the injection

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WHAT TO EXPECT AFTER THE PROCEDURE

You can expect some discomfort following a procedure. Not all patients experience this, but if you do, here are some helpful pointers to know:

After a Lumbar or Caudal Epidural Injection:

• Temporary increase in low back and/or leg pain for several days
• Improvement in back and leg pain may be noted in the first 3-5 days, but may be delayed for up to 6 weeks

After a Cervical Epidural Injection:

• Temporary increase in neck, upper back and/or arm pain for several days
• Improvement in arm pain may be noted in the first 3-5 days, but may be delayed for up to 2 weeks

After a Facet Joint or a Sacro-Iliac Joint Injection:

• Lumbar / Sacro-Iliac: Low back achiness, stiffness and a temporary increase in pain for 2-7 days
  Improvement may be noted in 3-5 days, but may be delayed up to 2 weeks
• Cervical: Neck, arm and shoulder achiness, stiffness and a temporary increase in pain for 2-7 days
  Improvement may be noted in 3-5 days, but may be delayed up to 2 weeks

After a Radiofrequency Procedure:

• Lumbar, Thoracic or Cervical: Increase in pain over the treated area for 2 to 4 weeks that slowly improves; pain relief is then noted after the post-procedure pain disappears

After a Nerve Block (Intercostal, Sympathetic, etc)

Pain relief for the duration of the anesthetic medication used (usually 4-8 hours); sympathetic nerve blocks, if they work, can give pain relief lasting weeks to months

After an Epiduroscopy Procedure:

There is usually an increase in back and/or leg pain that may last for 2-4 weeks; pain relief is then noted after the post-procedure pain disappears

After a Discography Procedure:

Since this is a Provocative Test Procedure to help identify which disk(s) is/are the source of your pain, you will have post-procedure pain that may last for 2-4 weeks

To help relieve your pain, place an ice pack on the injection site for 15-20 mins every 3-4 hours for the first 1-2 days. Keep activity to a minimum for the first day. Continue taking any pain medications given to you when you get home. Call the doctor if you may have any concerns or problems: (732) 607-9000

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What is Conscious Sedation?

When is conscious sedation used?
Conscious sedation is routinely used for medical procedures such as cardiac catheterization, upper and lower bowel exams, dental procedures and outpatient surgeries.

Are you unconscious?
No. When conscious sedation is used, the patient is aware of his or her surroundings but you don't care much about them. You are not under a general anesthetic. You are usually very sleepy, but can be easily awakened with touch or talking. The patient may feel like their speech is slurred. You may not remember the procedure after it is over because some medications given for conscious sedation cause amnesia (loss of memory of the event).

Will I be hooked up to a lot of equipment?
The nurses will monitor the patient's blood pressure, heart rate, and how well the patient is breathing.

Will I receive oxygen during the procedure?
Oxygen by way of a nasal cannula may be placed on the patient prior to sedation. This is routine during conscious sedation as the patient may breathe slower and not as deep as normal.

Will it take very long to recover from conscious sedation?
No, most of the time, patients wake up very quickly after their procedure. The patient is not allowed to drive home. Judgment can be affected by medications and it is important for the patient to not drive, operate dangerous equipment or sign any legal papers for 24 hours after receiving any medication for sedation.

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