In my area there is a severe shortage of kenalog and depo medrol. Any remaining stock is at least twice as expensive as before. I currently use dexamethasone for TFESI and kenalog for interlaminar and joints. Any experience using dex for interlaminar and joints? I’ve always been taught It does not work as well or last as long, but I have seen studies that supported use. Just curious about your real world experience.
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Dexamethasone
Started by sbp111
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Oh god here we go lol
Traumeel
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yup. end of thread as we have gone off the deep end again.
fwiw, do not use traumeel in a medicare patient.
fwiw, do not use traumeel in a medicare patient.
Agree....celestone is better than dex by a mile
I just realized I didn’t put traumeel in the appropriate color. Will fix now
To be clear to any fellows that may be reading this: don’t use traumeel. Ever.
I forget, what again is traumeel exactly
Me neither
Glad to hear that. Definitely not my experience. I used it for awhile when I ran out of depo and kenalog was not available. Lots of patients had little to no pain relief compared to previous for knee joints and hip bursitis.
I believe you, unfortunately in my little corner of the world it does virtually nothing
Constantly with me. One of my spine surgeon partners does a right L4-5 TFESI and the pt gets 9M, I repeat with Dex and I’m lucky if I get 8W, usually 4-6W. I fail to understand why this is recommended, but it’s what I do bc my career is not worth it.
agreed
i find that dex works well in certain circumstances.
dex works much better on inpatient population that needs an intervention to go home sooner rather than 3-4 days later when the particulate kicks in.
it also works well for transforaminals as opposed to a particulate in preventing embolism of the artery of Adamkiewicz....
do no harm.
dex works much better on inpatient population that needs an intervention to go home sooner rather than 3-4 days later when the particulate kicks in.
it also works well for transforaminals as opposed to a particulate in preventing embolism of the artery of Adamkiewicz....
do no harm.
Open Evidence data and clinical anecdotes seem mixed but more plausible for particulate/crystalline/depot forms of steroids to last longer
It seems dexamethasone first and then particulates if not durable may be reasonable for efficacy while dexamethasone only is reasonable for safety/speed
Celestone seems like the best balance for risk/benefit if you need to pick a depot steroid but it's not without risk, although neither is contrast/needle placement
It seems dexamethasone first and then particulates if not durable may be reasonable for efficacy while dexamethasone only is reasonable for safety/speed
Celestone seems like the best balance for risk/benefit if you need to pick a depot steroid but it's not without risk, although neither is contrast/needle placement
yep, I know which one you mean.
It's a fallacy to assume that betamethasone is "sorta safer" than depo/kenalog. The only safe steroid from a vascular occlusion standpoint is dex.
physiology in georgia is no different than elsewhere.
it works, just slightly less efficacious
