Ultrasound-guided tricompartmental blockade of the shoulder
Abstract
Introduction: Chronic shoulder pain is one of the most frequent causes of consultation for musculoskeletal pain. Physical and drug therapy usually result in little improvement and surgical intervention commonly fails. Tricompartmental blockade of the shoulder is an option when baseline therapy fails and ultrasonography is a tool that facilitates the approach, improves the efficacy and reduces the complications.
Objective: To determine the efficacy and safety of ultrasound-guided tricompartmental blockade of the shoulder in chronic pain patients.
Methods and materials: A descriptive, prospective, follow-up study was made of a cohort of 19 patients with chronic shoulder pain receiving ultrasound-guided tricompartmental blockade of the shoulder. Data were collected prior to the procedure with four, eight and sixteen week controls. Pain intensity was measured with the visual analog scale. Results:Average age was 58.89 years, 73.7% were females. All patients referred severe pain prior to the block. The percentage of patients with reduced pain in the four follow-up periods was 78.3%.
Conclusions: Chronic shoulder pain considerably affects the quality of life. Tricompartmen-tal blockade of the shoulder is an alternative when drug therapy fails, with good outcomes, although the scientific evidence is very scarce. In our study the ultrasound-guided tricom-partmental blockade of the shoulder is an effective and safe technique.
References
2. Gialanella B, Prometti P. Effects of corticosteroids injection in rotatorcuff tears. Pain Med. 2011;12:1559-65.
3. Matthieu JC, Bas JM, Gerrit JJ, Maarten C. Injection of the subacromial-subdeltoid bursa: Blindo or ultrasound-guided? Acta Orthopaedica. 2007;78:254-7.
4. Cunnington J, Marshall N, Hide G, Bracewell C, Isaacs J, Platt P, et al. A randomized, double blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis. Arthritis Rheum. 2010;62:1862-9.
5. Porat S, Leupold JA, Burnett KR, Nottage WM. Reliability of non-imaging-guided glenohumeral joint injection through rotator interval approach in patients undergoing diagnostic MR arthrography. AJR Am J Roentgenol. 2008;191:96-9.
6. Matthieu JC, Rutten M, Collins JM, Bas JM, Smeets JH, Janssen CM, et al. Glenohumeral joint injection: a comparative study of ultrasound and fluoroscopically guided techniques before MR arthrography. Eur Radiol. 2009;19:722-30.
7. Pichler W, Weinberg AM, Grechenig S, Tesch NP, Heidari N, Grechenig W. Intraarticular injection of the acromioclavicular joint. J Bone Joint Surg Br. 2009;91:1638-40.
8. Bisbinas I, Belthur M, Said H, Green M, Learmonth DJ. Accuracy of needle placement in ACJ injections. Knee Surg Sports Traumatol Arthrosc. 2006;14:762-5.
9. Peck E, Lai JK, Pawlina W, Smith J. Accuracy of ultrasound-guided versus palpation-guided acromioclavicular joint injections: A cadaveric study. PM&R. 2010;2: 817-21.
10. Sabeti-Aschraf M, Lemmerhofer B, Lang S, Schmidt M, Funovics PT, Ziai P, et al. Ultrasound guidance improves the accuracy of the acromioclavicular joint infiltration: A prospective randomized study. Knee Surg Sports Traumatol Arthrosc. 2011;19:292-5.
11. Shah N, Lewis M. Shoulder adhesive capsulitis: Systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract. 2007;57:662-7.
12. Carette S, Moffet H, Tardif J, Bessette L, Morin F, Frémont P, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: A placebo controlled trial. Arthritis Rheum. 2003;48:829-38.
13. Bain GI, van Riet RP, Gooi C, Ashwood N. The long-term efficacy of corticosteroid injection into the acromioclavicular joint using a dynamic fluoroscopic method. Int J Shoulder Surg. 2007;1:104-7.
14. Peng PW, Cheng P. Ultrasound-guided interventional procedures in pain medicine. a review of anatomy, sonoanatomy, and procedures. Part III: Shoulder. Reg Anesth Pain Med. 2011;36:592-605.
15. Arcila MA, Rivera RC, Campuzano D, Mejia MA, Martinez SM. Eficacia y seguridad del bloqueo de nervio supraescapular guiado por ultrasonido en pacientes con dolor crónico de hombro. Rev Colomb Anestesiol. 2013;41: 104-8.
Downloads
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
