THE ORAL DEXAMETHASONE EFFECTIVENESS IN REDUCING GASTROINTESTINAL AND NEUROLOGICAL SIDE EFFECTS OF METRIZAMIDE LUMBAR MYELOGRAPHY: A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Background: One of the most popular contrast agents is metrizamide which is also nonionic and the reason behind its high application in lumbar myelography is because of its high diagnostic quality as compared to the older contrast agents such as Pantopaque. But it has a range of side effects, especially gastrointestinal in nature, nausea, vomiting, headaches and others. Previous research has indicated that these side effects can be decreased by steroid treatments. The study was conducted to determine the effectiveness of oral dexamethasone in the management of gastrointestinal and other adverse effects that are prevalent with metrizamide lumbar myelography. Methods: It was a double-blinded placebo-controlled study together with 145 adult patients with either chronic low back and/or leg pain and underwent lumbar metrizamide myelography. At intervals, the participants were randomly grouped into dexamethasone (4 mg) and placebo before and after the procedure. The severity of the symptoms was evaluated by the use of a 24-item symptom checklist prior to the procedure and 24 hours post-procedure. Chi-square tests, correlation coefficients, and post hoc tests were the methods used to analyze the data to determine the relationship between treatment and changes in the symptoms. Results: The findings demonstrated that there was a statistically significant decrease in vomiting symptoms in the dexamethasone group whereby 10.5% patients in the placebo group reported increased vomiting symptoms as compared to 0 in the dexamethasone group ( 2 -test = 4.48, p = 0.034). The difference in other symptoms like headache and nausea was not statistically significant although there was a reduction. Pain in the legs and weakness in legs or feet were also significantly improved in the dexamethasone group, also not significantly. The results of the analysis also indicated a positive relationship between nausea and the scores on MMPI hysteria in the group of dexamethasone. Conclusion: In patients who underwent metrizamide lumbar myelography, oral dexamethasone was effective in the reduction of some gastrointestinal side effects especially vomiting. Even though the drug failed to alleviate all the side effects, its protective effects were specifically noticeable in the elderly patients. Personality traits also were recognized as having an impact on reporting of nausea and other symptoms in the study.