Sciatic neuropathies secondary to intramuscular injections

Abstract

Objective: Parenteral drug administration through intramuscular gluteal route is a common clinical practice. The most frequent and serious complication of this procedure is sciatic nerve injury. Our aim is to focus on this complication, and to discuss it in the light of the literature.

Method: Forty-four cases of sciatic neuropathy due to gluteal injections were evaluated in 43 patients who referred to our hospital between January 1993 and December 2000.

Results: The mean age of 10 female (23.3 %) and 33 male (76.7 %) patients was 40.8±20.9 years (range 4 to 78). Eight patients (18.6 %) were in the childhood period. The neuropathy was located on the right side in 18 of ttııe patierıts, on the left in 24 of them, and there was bilateral involvement in one ,case. Thirty-six, injections (83.9 %) were performed by the medical staff. Whereas, seven of thern were done 'by neighbors or relatives of the patients and one injection was peıiformed by the patient himself. That is, 8 injections (16.1 %) were done by unlicensed individuals. NSAIDs, antibiotics and analgesics were the most frequent medications, the rates of which were 31.8 %, 18.2. %, and 18.2 % respectively.

Conclusion: SN secondary to gluteal injections is not a rare complication, at all. Direct trauma to the nerve is the most common cause. Since injection into the vasa nervorum or into the periphery or body of the nerve itself has been considered to be responsible for the ischemic and toxic; mechanisms, injection site and technique seems to be foremost important. We think that precautions must be taken in order to restrict unlicensed performance and better post-graduate: ongoing programs should be undertaken to reduce comliplications.