From the *Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada; and †Department of Anatomy, University of Toronto, Toronto, Ontario, Canada.
Anesth Analg. 2017 Mar;124(3):966-971. doi: 10.1213/ANE.0000000000001864.
Trochanteric bursa (TB) injection with local anesthetic and corticosteroid is a treatment for patients suffering from greater trochanteric pain syndrome. Both landmark (LM)-guided and ultrasound (US)-guided methods have been used, but their accuracies have not been determined. This study examined the accuracy of these injections with cadaveric dissection.
Twenty-four hip specimens were randomized to receive TB injections with methylene blue under either LM-guided or US-guided approach. After dissection, the locations of the dye were classified into 3 categories: intrabursal, extrabursal, or combined intrabursal and extrabursal. The presence of dye in the intrabursal space with or without extrabursal leak was considered a successful injection. Accuracy was defined as the percentage of successful injection.
The accuracies of the LM-guided and US-guided injection were 0.67 (95% confidence interval 0.35-0.90) and 0.92 (95% confidence interval 0.62-1.00), respectively, with no significant difference.
This is the first cadaveric study examining the accuracy of both the US-guided and LM-guided techniques for TB injection. Future clinical studies are required to compare the outcomes of LM-guided and US-guided greater trochanteric pain syndrome injection.
在局部麻醉和皮质类固醇的作用下，对转子囊（TB）进行注射是治疗转子间疼痛综合征患者的一种方法。目前，已经使用了基于解剖标志（LM）和超声（US）引导的方法，但它们的准确性尚未确定。本研究通过尸体解剖来检查这些注射的准确性。
将 24 个髋关节标本随机分为两组，分别采用 LM 引导和 US 引导下进行美蓝注射。解剖后，将染料的位置分为 3 类：囊内、囊外或囊内外混合。如果染料位于囊内且无囊外渗漏，则认为注射成功。准确性定义为成功注射的百分比。
LM 引导和 US 引导注射的准确性分别为 0.67（95%置信区间 0.35-0.90）和 0.92（95%置信区间 0.62-1.00），差异无统计学意义。
这是首次对 US 引导和 LM 引导 TB 注射技术的准确性进行的尸体研究。需要进行未来的临床研究来比较 LM 引导和 US 引导的转子间疼痛综合征注射的结果。
