Faculty Collaboration Database

Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection. Pain Res Manag 2018;2018:8474127

Date

05/15/2018

Pubmed ID

29755622

Pubmed Central ID

PMC5883975

DOI

10.1155/2018/8474127

Scopus ID

2-s2.0-85053796373 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

BACKGROUND: Cervical interlaminar epidural steroid injections (ESIs) are commonly performed procedures to treat painful cervical radiculopathy, but little is known about the systemic absorption and serum levels of steroids following injection. The primary objective of this study was to investigate the pharmacokinetics of fluoroscopy-guided cervical epidural-administered triamcinolone acetonide in a cohort of patients with cervical radicular pain seeking treatment in a pain medicine clinic.

METHODS: The study cohort included eight patients undergoing a fluoroscopically guided C7-T1 interlaminar ESI at a pain medicine specialty clinic. Blood was collected prior to the ESI and on days 1, 2, 4, 6, 8, 14, 21, 28, 35, and 42 following the injection. The sample extract was analyzed by tandem mass spectrometry.

RESULTS: The terminal elimination half-life of cervical epidural-administered triamcinolone in a noncompartmental analysis was 219 hours. In the noncompartmental analysis, peak triamcinolone concentrations of 5.4 ng/mL were detected within 22.1 hours after administration.

CONCLUSIONS: The pharmacokinetics of cervical epidural-administered triamcinolone is consistent with our previous study of lumbar ESI, demonstrating that the elimination half-life is longer than that which has been reported following intravenous triamcinolone. The elimination half-life was shorter following cervical ESI than that which has been reported following lumbar ESI.

Author List

Lamer TJ, Dickson RR, Gazelka HM, Nicholson WT, Reid JM, Moeschler SM, Hooten WM

Author

Rozalin Thapa DO Assistant Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Anti-Inflammatory Agents
Cohort Studies
Female
Fluoroscopy
Humans
Injections, Epidural
Male
Middle Aged
Pain Measurement
Radiculopathy
Statistics, Nonparametric
Time Factors
Triamcinolone