Kim Sang Jun, Gee Albert O, Hwang Jung Min, Kwon Jeong Yi
Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Samsung Medical Center, Gangnam-Gu, Irwonro, 50th, Seoul, 135-710, Republic of Korea.
Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA.
J Clin Ultrasound. 2015 Jul-Aug;43(6):353-60. doi: 10.1002/jcu.22201. Epub 2014 Jun 26.
To validate the usefulness of subacromial bursa lidocaine for determination of the therapeutic steroid injection site in patients with adhesive capsulitis
Ninety-two patients with adhesive capsulitis were randomly divided into the LC (lidocaine test) group (n = 46), in which LC injection was performed at the subacromial bursa prior to therapeutic steroid injection, and GH (glenohumeral) group (n = 46), in which the steroid was injected into the GH. Patients in the LC group received steroid injection at the subacromial bursa or GH according to the result of the LC. Both groups underwent the same exercise protocol. Improvement of the shoulder pain was checked at 2 weeks and 3 months postinjection and expressed on an ordinal scale. Passive range of motion was recorded preinjection, and 2 weeks and 3 months postinjection.
Two weeks postinjection, 37 patients expressed "much improved" and 7 patients expressed "slightly improved" pain levels in the LC group, whereas 18 patients each expressed "much improved" and "slightly improved" pain levels in the GH group, which was significantly different (p < 0.01). This difference was maintained 3 months postinjection (p < 0.01). Passive range of motion in all directions improved significantly 3 months postinjection in both the LC and GH groups (p < 0.01). However, there was no significant difference between the LC and GH groups.
We found that subacromial lidocaine injection prior to steroid injection resulted in better improvement of pain than conventional GH injection for patients with adhesive capsulitis.
验证肩峰下滑囊利多卡因注射在确定肩周炎患者治疗性类固醇注射部位中的作用。
92例肩周炎患者被随机分为LC（利多卡因试验）组（n = 46），在治疗性类固醇注射前于肩峰下滑囊进行LC注射；以及GH（盂肱关节）组（n = 46），将类固醇注射到盂肱关节。LC组患者根据LC结果在肩峰下滑囊或盂肱关节接受类固醇注射。两组都采用相同的运动方案。在注射后2周和3个月检查肩部疼痛的改善情况，并以序数量表表示。记录注射前、注射后2周和3个月时的被动活动范围。
注射后2周，LC组37例患者表示疼痛程度“明显改善”，7例患者表示“稍有改善”，而GH组各有18例患者表示疼痛程度“明显改善”和“稍有改善”，差异有统计学意义（p < 0.01）。注射后3个月，这种差异仍然存在（p < 0.01）。注射后3个月，LC组和GH组各方向的被动活动范围均有显著改善（p < 0.01）。然而，LC组和GH组之间没有显著差异。
我们发现，对于肩周炎患者，在类固醇注射前进行肩峰下利多卡因注射比传统的盂肱关节注射能更好地改善疼痛。
