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Practice Advisory: Use of Gadolinium-Based Contrast Agents in Interventional Pain Procedures

Mar 26, 2021, 08:39 AM by ASRA

An international panel of experts has published a practice advisory on the risks of using gadolinium-based in interventional pain procedures including nephrogenic systemic fibrosis, gadolinium brain deposition/retention, and encephalopathy and death after an unintentional intrathecal gadolinium injection.

An international panel of experts representing 11 multinational and multispecialty organizations based these statements and recommendations on a comprehensive review of the literature up to December 31, 2019. 


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.

Read the article in Anesthesia & Analgesia.

This practice advisory was first published March 26, 2021, and will be reviewed again in 2026.

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