Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection
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 t...
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doaj-b78098d70aad4342bf767d175171ec042020-11-24T20:52:38ZengHindawi LimitedPain Research and Management1203-67651918-15232018-01-01201810.1155/2018/84741278474127Serum Triamcinolone Levels following Cervical Interlaminar Epidural InjectionTim J. Lamer0Rozalin R. Dickson1Halena M. Gazelka2Wayne T. Nicholson3Joel M. Reid4Susan M. Moeschler5W. Michael Hooten6Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USADepartment of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USADepartment of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USADepartment of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USADivision of Medical Oncology, Mayo Clinic College of Medicine, Rochester, MN, USADepartment of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USADepartment of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN, USABackground. 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.http://dx.doi.org/10.1155/2018/8474127 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tim J. Lamer Rozalin R. Dickson Halena M. Gazelka Wayne T. Nicholson Joel M. Reid Susan M. Moeschler W. Michael Hooten |
spellingShingle |
Tim J. Lamer Rozalin R. Dickson Halena M. Gazelka Wayne T. Nicholson Joel M. Reid Susan M. Moeschler W. Michael Hooten Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection Pain Research and Management |
author_facet |
Tim J. Lamer Rozalin R. Dickson Halena M. Gazelka Wayne T. Nicholson Joel M. Reid Susan M. Moeschler W. Michael Hooten |
author_sort |
Tim J. Lamer |
title |
Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection |
title_short |
Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection |
title_full |
Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection |
title_fullStr |
Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection |
title_full_unstemmed |
Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection |
title_sort |
serum triamcinolone levels following cervical interlaminar epidural injection |
publisher |
Hindawi Limited |
series |
Pain Research and Management |
issn |
1203-6765 1918-1523 |
publishDate |
2018-01-01 |
description |
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. |
url |
http://dx.doi.org/10.1155/2018/8474127 |
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