Park Chan-Woong, Cho Woo-Chul, Son Byung-Chul
Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Neurotrauma. 2019 Apr 8;15(1):61-66. doi: 10.13004/kjnt.2019.15.e4. eCollection 2019 Apr.
Iatrogenic injuries due to intramuscular (IM) injection, although less frequently reported than before, are still common. The sciatic nerve is the most commonly injured nerve because of an IM injection owing to its large size and the buttock being a common injection site. Iatrogenic injury to the sciatic nerve resulting from a misplaced gluteal IM injection is a persistent problem worldwide affecting patients in economically rich and poor countries alike. The consequences of sciatic nerve injection injury (SNII) are potentially devastating and may result in serious neurological and medico-legal problems. A 68-year-old male presented with intractable neuropathic pain from SNII that occurred during gluteal IM injection of an analgesic for post-appendectomy pain. This chronic SNII pain did not improve despite his gradual recovery from weakness in the left foot. Partial improvement was seen following an external neurolysis, performed three months post-appendectomy. SNII is a preventable complication of gluteal IM injection. While the complete avoidance of gluteal IM injection is desirable, should need arise, the use of an appropriate administrative technique is recommended.
尽管与过去相比，因肌肉注射（IM）导致的医源性损伤报告频率有所降低，但仍然很常见。坐骨神经是因肌肉注射而最常受损的神经，这是由于其体积较大且臀部是常见的注射部位。因臀肌肌肉注射位置不当导致的坐骨神经医源性损伤是一个全球性的持续性问题，无论经济富裕还是贫穷的国家，患者都会受到影响。坐骨神经注射损伤（SNII）的后果可能是毁灭性的，并可能导致严重的神经学和医疗法律问题。一名68岁男性因在臀部肌肉注射用于阑尾切除术后疼痛的镇痛药时发生坐骨神经注射损伤，出现顽固性神经性疼痛。尽管他左脚的无力逐渐恢复，但这种慢性坐骨神经注射损伤疼痛并未改善。阑尾切除术后三个月进行了外部神经松解术，疼痛有部分改善。坐骨神经注射损伤是臀肌肌肉注射可预防的并发症。虽然完全避免臀肌肌肉注射是理想的，但如果有需要，建议采用适当的注射技术。
