IPSIS Safety Practices Updated to Address GBCA Recommendations from Multisociety Practice Advisory

The IPSIS Safety Practices have been updated to include recommendations regarding use of gadolinium-based contrast agents (GBCA). The updates are based on the recently published, IPSIS-endorsed, multisociety practice advisory — 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.

For many procedures addressed in the Safety Practices, the new recommendations indicate that GBCA should be administered only when necessary and encourage weighing the clinical benefit of the treatment against the unknown potential risk of gadolinium deposition in the brain. Physicians are advised to adequately explain to patients the risks of GBCA administration if it is deemed necessary for a procedure where there is very low risk of possible unintentional intrathecal administration. For epidural injections, where there is a higher risk of unintentional intrathecal administration, there are additional recommendations cautioning against use of GBCA. If GBCA is considered essential and is to be injected near the epidural/subarachnoid space, measures should be employed to avoid advancement of the need tip into the subarachnoid space and the lowest possible volume of GBCA should be used. Appropriate radiographic imaging should be considered to investigate the occurrence of intrathecal or subdural administration, if suspected.

Click here to view the updated Safety Practices. IPSIS members can access the full set in a single PDF document.🔒

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