Triamcinolone Acetonide: Triamcinolone acetonide is a synthetic corticosteroid. Corticosteroids are hormones that are produced naturally by the body. This class of compounds contains the most potent anti-inflammatory drugs available to us. They work by inhibiting certain reactions in cells that are responsible for causing allergic responses and inflammation. Triamcinolone acetonide is a potent and long lasting version of a corticosteroid. Unfortunately, prolonged exposure to corticosteroids can cause high intraocular pressure and induce cataract formation.
By using a high frequency ultrasound probe the wrist is imaged by placing the probe transverse across dorsiflexed wrist. The median nerve and ulnar artery is identified. At the level of the distal wrist crease, the needle is passed into the skin superficial to the ulnar artery, penetrating the flexor retinaculum. The needle is advanced toward the median nerve. The steroid solution is injected just under the flexor retinaculum then retracted and redirected deeper to the ulnar side of the median nerve. This allows the median nerve to be completely surrounded with the steroid solution. [ 3 ]