COMPLICATIONS OF JOINT, TENDON, AND MUSCLE INJECTIONS.
COMPLICATIONS OF JOINT, TENDON, AND MUSCLE INJECTIONS.
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DOI：
10.1053/j.trap.2007.05.006
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发表时间：
2007-07-01
期刊：
影响因子：
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通讯作者：
Abdi, Salahadin
中科院分区：
文献类型：
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作者：
Cheng, Jianguo;Abdi, Salahadin
预防并发症是疼痛管理中患者护理的最重要方面之一。本研究的目的是回顾医学文献中记录的与介入性疼痛管理相关的并发症，特别是与关节、肌腱和肌肉注射相关的并发症。我们从1966年至2006年11月进行了Medline研究，使用关键词并发症、注射、射频、闭合声明、小关节、椎体关节、骶髂关节、肩关节、髋关节、膝关节、腕管、囊和触发点。我们发现了超过35篇相关论文，包括原创文章、病例报告和综述。最常见的并发症似乎是感染，几乎所有这些注射都与感染有关。这些感染包括脊椎炎、脓毒性关节炎、硬膜外脓肿、坏死性筋膜炎、骨髓炎、气性坏疽和白色念珠菌关节炎。其他并发症包括脊髓损伤和周围神经损伤、气胸、空气栓塞、注射部位疼痛或肿胀、化学性脑膜炎、滑膜肉芽肿性炎症、无菌性急性关节炎、药物性皮肤栓塞、骨骼肌毒性以及肌腱和筋膜破裂。我们认为，许多感染性并发症可以通过严格遵守无菌技术来预防，而其他一些并发症可以通过明确了解相关解剖结构来改进手术技术来最大限度地减少。
Prevention of complications is one of the most important aspects of patient care in pain management. The objective of this study is to review documented complications in medical literature that are associated with interventional pain management, specifically those associated with joint, tendon, and muscle injections. We conducted Medline research from 1966 to November 2006 using keywords complication, injection, radiofrequency, closed claim, facet, zygophyseal joint, sacroiliac joint, shoulder, hip, knee, carpel tunnel, bursa, and trigger point. We found over 35 relevant papers in forms of original articles, case reports, and reviews. The most common complications appear to be infections that have been associated with virtually all of these injections. These infections include spondylodiscitis, septic arthritis, epidural abscess, necrotizing fasciitis, osteomyelitis, gas gangrene, and albicans arthritis. Other complications include spinal cord injury and peripheral nerve injuries, pneumothorax, air embolism, pain or swelling at the site of injection, chemical meningism, granulomatous inflammation of the synovium, aseptic acute arthritis, embolia cutis medicamentosa, skeletal muscle toxicity, and tendon and fascial ruptures. We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the procedural techniques with a clear understanding of the relevant anatomies.