CEM ZEKİ ESENYEL, Meltem ESENYEL, Rıdvan YEŞİLTEPE, SEMİH AYANOĞLU, AHMET MURAT BÜLBÜL, Mustafa ŞİRVANCI, AYHAN NEDİM KARA

Subakromiyal sıkışma sendromunda steroid enjeksiyonunun doğru şekilde uygulanması ile omuz ağrısı ve fonksiyonu arasındaki ilişki

Amaç: Subakromiyal sıkışma sendromlu hastalarda lokal anestetik ve steroid enjeksiyonun doğru şekilde yapılmasının ağrı şiddeti ve omuz fonksiyonlarıyla, ilişkisi araştırıldı. Çalışma planı: Çalışmaya, omuz ağrısı şikayeti iki aydan fazla süren, Subakromiyal sıkışma sendromlu 48 hasta (29 kadın, 19 erkek; ort. yaş 46.5; dağılım 23-58) alındı. Enjeksiyonun istenen bölgeye ulaşıp ulaşmadığını görüntüleyebilmek için steroid ve lokal anestetik karışımına kontrast madde eklendi. Enjeksiyon, subakromiyal bursaya anterolateral bölgeden yapıldı. Enjeksiyondan hemen sonra omuz grafileri ile verilen maddelerin doğru yerde olup olmadığı araştırıldı. Enjeksiyon öncesinde, yarım saat sonra ve iki hafta sonra elde edilen görsel ağrı skalası ve Constant değerleri ve omuz hareketleri karşılaştırıldı. Sonuçlar: Enjeksiyonun 42 hastada (%87.5) subakromiyal bursaya ulaştığı; altı hastada (%12.5) ulaşmadığı saptandı. Enjeksiyondan yarım saat sonraki değerlendirmelerde, her iki hasta grubunda da anlamlı iyileşme kaydedildi (p

Anahtar Kelimeler:

Omuz sıkışma sendromu, Anestezikler, lokal, Anti-enflamatuvar ajanlar, Hareket açıklığı, eklem, İlaç tedavisi, Enjeksiyon, eklem içi, Ağrı

The correlation between the accuracy of steroid injections and subsequent shoulder pain and function in subacromial impingement syndrome

Objectives: We assessed the relationship between proper placement of corticosteroid injections and subsequent shoulder function and pain in subacromial impingement syndrome. Methods: The study included 48 patients (29 women, 19 men; mean age 46.5 years; range 23 to 58 years) with subacromial impingement syndrome, whose complaints of shoulder pain lasted more than two months. To monitor the site of injection, contrast material was added to a mixture of steroid and local anesthetic solution. Injections were delivered into the subacromial bursa by an anterolateral approach. Radiographs of the joint were taken immediately afterwards to ensure the accurate placement of the injection. Shoulder function and pain were evaluated by visual pain scale, range of movement of the joint, and Constant scores before treatment, and half an hour and two weeks after the injections. Results: The injections were placed accurately in 42 patients (87%), while in six patients (12.5%), delivery to the target site failed. Statistically significant improvements were observed in both groups half an hour after the injections (p<0.05). However, two weeks after the treatment evaluations showed that failure to obtain an accurate placement was associated with return to pretreatment values, while significant improvement continued in the other group. Conclusion: Failure to deliver injections to the target site may be decreased by increased utilization of visualization and imaging methods.

Keywords:

Shoulder Impingement Syndrome, Anesthetics, Local, Anti-Inflammatory Agents, Range of Motion, Articular, Drug Therapy, Injections, Intra-Articular, Pain,

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