Kongsagul Sussaya, Vitoonpong Timporn, Kitisomprayoonkul Wasuwat, Tantisiriwat Natthiya
Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Rehabilitation Medicin, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
J Med Ultrasound. 2019 Dec 26;28(2):99-103. doi: 10.4103/JMU.JMU_54_19. eCollection 2020 Apr-Jun.
BACKGROUND: Based on the histological confirmation of the presence of nerve structure in the fascia, hence, myofascial pain was treated by the mechanism referred to as interfascial block. To date, the studies of physiological saline for treating patients with myofascial pain has been limited. Ultrasound (US) guided with physiological saline injection (PSI) technique has been routinely practiced among patients with myofascial pain in outpatient service at the Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital. The main objective of this present study is to find the overview data including the percentage of patients responding, acceptable pain period, and adverse events. MATERIALS AND METHODS: Electronic medical reports among 142 patients receiving US-guided PSI from August 1, 2016, to November 20, 2017, at the Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, were retrospectively reviewed by the first author. Procedures were performed by the last author. The analysis was independently performed by the first author. RESULTS: One hundred and forty-two patients with complete medical records were compatible with analysis. The average age of patients was 55 years. Most of the patients were female (68.3%). Most of the patients (76.8%) had chronic suffering from myofascial pain. Approximately half of the patients (56.4%) are currently received pain-relieving medications. Upper trapezius muscle (19.5%) was the most common muscle receiving the procedure, followed by multifidus (10.0%) and quadratus lumborum (9.5%). Most of the patients (86.8%) received the procedure one muscle. Approximately 30% of the patients were able to stop pain-relieving medications after the procedure. The median of acceptable pain period was 63 days. The percentage of patients having an acceptable pain period >3 months was 43.9%. No major adverse events were demonstrated. CONCLUSION: US-guided PSI technique demonstrated pain reduction in 72.8% of the analyzed patients, with an acceptable pain period of 63 days. No major adverse events were demonstrated among all the patients. This technique should be considered as another invasive procedure for eradication myofascial trigger point.
背景：基于筋膜中神经结构存在的组织学证实，因此，肌筋膜疼痛通过称为筋膜间阻滞的机制进行治疗。迄今为止，关于生理盐水治疗肌筋膜疼痛患者的研究有限。在朱拉隆功国王纪念医院康复医学科门诊，超声（US）引导下生理盐水注射（PSI）技术已常规应用于肌筋膜疼痛患者。本研究的主要目的是获取包括患者反应百分比、可接受的疼痛持续时间和不良事件在内的总体数据。 材料与方法：第一作者对2016年8月1日至2017年11月20日在朱拉隆功国王纪念医院康复医学科接受超声引导下生理盐水注射的142例患者的电子病历进行回顾性研究。操作由最后一位作者进行。分析由第一作者独立完成。 结果：142例有完整病历的患者符合分析要求。患者的平均年龄为55岁。大多数患者为女性（68.3%）。大多数患者（76.8%）患有慢性肌筋膜疼痛。约一半患者（56.4%）目前正在服用止痛药物。斜方肌上部（19.5%）是接受该操作最常见的肌肉，其次是多裂肌（10.0%）和腰方肌（9.5%）。大多数患者（86.8%）接受该操作的是一块肌肉。约30%的患者在操作后能够停用止痛药物。可接受疼痛持续时间的中位数为63天。疼痛持续时间>3个月的患者百分比为43.9%。未出现重大不良事件。 结论：超声引导下生理盐水注射技术在72.8%的分析患者中显示出疼痛减轻，可接受的疼痛持续时间为63天。所有患者中均未出现重大不良事件。该技术应被视为根除肌筋膜触发点的另一种侵入性操作。
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