Serum triamcinolone levels following interlaminar epidural injection

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Lumbar interlaminar epidural steroid injections (ESIs) are one of the most commonly performed procedures in pain medicine, but little is known about the serum levels of steroids following injection into the epidural space. The primary objective of this study was to investigate the pharmacokinetics of fluoroscopy-guided epidural-administered triamcinolone acetonide in a cohort of patients with chronic low-back pain seeking treatment in a pain medicine clinic. Methods: The study cohort included 10 patients undergoing a fluoroscopically guided L4-L5 or L5-S1 lumbar 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 epidural-administered triamcinolone in a noncompartmental analysis was 523 hours. In the noncompartmental analysis, peak triamcinolone concentrations of 4.1 ng/mL were detected within 24 hours after administration. Conclusions: The pharmacokinetics of epidural-administered triamcinolone is consistent with previously observed adverse effects of the drug on endocrine function. The pharmacokinetics of other epidural-administered steroids should be determined and incorporated in clinical trials to investigate the potential associations between serum levels, clinical outcomes, and potential adverse endocrine effects.

Original languageEnglish (US)
Pages (from-to)75-79
Number of pages5
JournalRegional Anesthesia and Pain Medicine
Volume41
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Epidural Injections
Triamcinolone
Steroids
Serum
Pharmacokinetics
Medicine
Epidural Space
Pain Clinics
Pain
Triamcinolone Acetonide
Injections
Fluoroscopy
Tandem Mass Spectrometry
Low Back Pain
Half-Life
Cohort Studies
Clinical Trials
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Hooten, W. M., Nicholson, W. T., Gazelka, H. M., Reid, J. M., Moeschler, S. M., & Lamer, T. J. (2016). Serum triamcinolone levels following interlaminar epidural injection. Regional Anesthesia and Pain Medicine, 41(1), 75-79. https://doi.org/10.1097/AAP.0000000000000333

Serum triamcinolone levels following interlaminar epidural injection. / Hooten, W. Michael; Nicholson, Wayne T.; Gazelka, Halena M.; Reid, Joel M; Moeschler, Susan M.; Lamer, Tim J.

In: Regional Anesthesia and Pain Medicine, Vol. 41, No. 1, 2016, p. 75-79.

Research output: Contribution to journalArticle

Hooten, W. Michael ; Nicholson, Wayne T. ; Gazelka, Halena M. ; Reid, Joel M ; Moeschler, Susan M. ; Lamer, Tim J. / Serum triamcinolone levels following interlaminar epidural injection. In: Regional Anesthesia and Pain Medicine. 2016 ; Vol. 41, No. 1. pp. 75-79.
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