Abstract
IntroductionTo determine the accuracy of landmark-guided shoulder joint injections (LGI) with point-of-care ultrasound for patients with anterior shoulder dislocations.MethodsPatients with anterior shoulder dislocations who underwent LGI were enrolled at our tertiary-care and trauma center. LGI attempts were recorded by an ultrasound fellowship-trained ED physician who determined if they were placed successfully. Pain and satisfaction scores were recorded.ResultsA total of 34 patients with anterior shoulder dislocation and their treating ED physicians were enrolled. 41.1% of all LGI were determined to be misplaced (n=14). Patients with successful LGI had a greater decrease in mean pain scores post-LGI.ConclusionsLGI had a substantial failure rate in our study. Using ultrasound-guidance to assist intra-articular injections may increase its accuracy and thus reduce pain and the need for subsequent procedural sedation.
Highlights
To determine the accuracy of landmark-guided shoulder joint injections (LGI) with point-of-care ultrasound for patients with anterior shoulder dislocations
Studies have not determined the rate at which landmark-guided shoulder joint injections (LGI) truly deposit local anesthetic into the joint space
The current literature suggests that intra-articular injections of the shoulder with local anesthetic can be an effective alternative to procedural sedation and analgesia (PSA) for providing analgesia during reduction,[4,5,6,7,8,9] especially in patients
Summary
To determine the accuracy of landmark-guided shoulder joint injections (LGI) with point-of-care ultrasound for patients with anterior shoulder dislocations. Importance Shoulder dislocations are the most common joint injury treated in the ED, with anterior glenohumeral dislocation accounting for 95-97% of dislocations.[1] In most institutions, the preferred method for providing the necessary pain relief and muscle relaxation to facilitate reduction involves procedural sedation and analgesia (PSA), typically with a combination of opioids and benzodiazepines.[2] often effective, PSA can be time and resource intensive, requiring close monitoring by medical personnel due to the risk for severe complications such as central nervous system and respiratory depression.[3] In light of this, the current literature suggests that intra-articular injections of the shoulder with local anesthetic can be an effective alternative to PSA for providing analgesia during reduction,[4,5,6,7,8,9] especially in patients
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