TY - JOUR
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
N1 - Funding Information:
,e study was funded by the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Publisher Copyright:
© 2018 Tim J. Lamer et al.
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.
UR - http://www.scopus.com/inward/record.url?scp=85053796373&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053796373&partnerID=8YFLogxK
U2 - 10.1155/2018/8474127
DO - 10.1155/2018/8474127
M3 - Article
C2 - 29755622
AN - SCOPUS:85053796373
VL - 2018
JO - Pain Research and Management
JF - Pain Research and Management
SN - 1203-6765
M1 - 8474127
ER -