Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection

Tim J. Lamer; Rozalin R. Dickson; Halena M. Gazelka; Wayne T. Nicholson; Joel M. Reid; Susan M. Moeschler; W. Michael Hooten

doi:10.1155/2018/8474127

Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection

Tim J. Lamer, Rozalin R. Dickson, Halena M. Gazelka, Wayne T. Nicholson, Joel M. Reid, Susan M. Moeschler, W. Michael Hooten

Research output: Contribution to journal › Article › peer-review

9 Scopus 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.

Original language	English (US)
Pages (from-to)	8474127
Number of pages	1
Journal	Pain research & management
Volume	2018
DOIs	https://doi.org/10.1155/2018/8474127
State	Published - 2018

ASJC Scopus subject areas

Neurology
Anesthesiology and Pain Medicine

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@article{496a8a8b2b53475c944bf439f96cb88e,

title = "Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection",

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 = "Lamer, {Tim J.} and Dickson, {Rozalin R.} and Gazelka, {Halena M.} and Nicholson, {Wayne T.} and Reid, {Joel M.} and Moeschler, {Susan M.} and Hooten, {W. Michael}",

year = "2018",

doi = "10.1155/2018/8474127",

language = "English (US)",

volume = "2018",

pages = "8474127",

journal = "Pain Research and Management",

issn = "1203-6765",

publisher = "Pulsus Group Inc.",

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T1 - Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection

AU - Lamer, Tim J.

AU - Dickson, Rozalin R.

AU - Gazelka, Halena M.

AU - Nicholson, Wayne T.

AU - Reid, Joel M.

AU - Moeschler, Susan M.

AU - Hooten, W. Michael

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

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JO - Pain Research and Management

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Serum Triamcinolone Levels following Cervical Interlaminar Epidural Injection

Abstract

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