The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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The Effect of Three 20 mg Caudal Epidural Injections of Triamcinolon on the Blood Glucose, ACTH and Cortisol Concentrations in the Elderly Women

노인에서 경막외강에 3회 분할 투여된 Triamcinolone 60 mg이 혈중 포도당, ACTH와 Cortisol에 미치는 영향

  • Goh, Jee Eun (Department of Anesthesiology and Pain Medicine, College of Medicine, Gyeongsang National University) ;
  • Min, Soon (Chosun College of Nursing) ;
  • Jeong, Young Ju (Chosun College of Nursing) ;
  • Lee, Heon Keun (Department of Anesthesiology and Pain Medicine, College of Medicine, Gyeongsang National University)
  • 고지은 (경상대학교 의과대학 마취통증의학교실) ;
  • 민순 (조선간호대학교) ;
  • 정영주 (조선간호대학교) ;
  • 이헌근 (경상대학교 의과대학 마취통증의학교실)
  • Received : 2005.03.28
  • Accepted : 2005.05.07
  • Published : 2005.06.30
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Abstract

Background: Epidural steroid injections (ESI) have been used widely for the treatment of back and radiating extremity pain. Although its effects on the metabolic and endocrine system have been studied, the effects following repeated injections remain to be determined. We studied the effects of three repeated caudal epidural injections of low dose triamcinolone. Methods: the subject were 10 elderly women with spinal stenosis. Caudal epidural injections were performed biweekly. Triamcinolone (20 mg), mixed with 15 ml of 0.25% lidocaine, was used as the ESI injectate. The procedures were performed with the patient in the prone position. Blood sampling was performed just before the first injection, and used as the baseline, and then just before each injection on the same day of the 2nd and 4th weeks, with the last samples taken 2 weeks after the third injection. Results: The blood glucose concentrations showed no significant changes. The blood cortisol and ACTH concentrations were significantly decreased after the first injection, but there were no further decreases after each of the subsequent injections. The cortisol concentrations were maintained within the normal range. Conclusion: Caudal epidural injections, with low dose triamcinolone, suppressed the hypothalamus-pituitary-adrenal (HPA) axis, but no further suppression followed the subsequent repeated injections. Three consecutive caudal injections at 2 week intervals seems to be a safe procedure.

Keywords

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