Intra-articular steroid injection in dogs

18 trials (1179 participants) were included in this updated review . The injection sites varied from epidural sites and facet joints (. intra-articular injections, peri-articular injections and nerve blocks) to local sites (. tender- and trigger points). The drugs that were studied consisted of corticosteroids, local anesthetics and a variety of other drugs. The methodological quality of the trials was limited with 10 out of 18 trials rated as having a high methodological quality. Statistical pooling was not possible due to clinical heterogeneity in the trials. Overall, the results indicated that there is no strong evidence for or against the use of any type of injection therapy .

The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.

IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. Situations which may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the disease process, the patient’s individual drug responsiveness, and the effect of patient exposure to stressful situations not directly related to the disease entity under treatment. In this latter situation it may be necessary to increase the dosage of the corticosteroid for a period of time consistent with the patient’s condition. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.

The subacromial corticosteroid injections for the rotator cuff disease and intra-articular steroid injection for adhesive capsulitis are quite beneficial. However the impact of these injections can be short-lived. Experts suggest that a more extensive research is required to study the efficacy of the corticosteroid injections for shoulder pain. There are other issues that also need to be clarified. The most important amongst these is whether the factors like accuracy of needle placement, anatomical site, frequency, dose and type of corticosteroid influences the efficacy of the injection.

Intra-articular steroid injection in dogs

intra-articular steroid injection in dogs

The subacromial corticosteroid injections for the rotator cuff disease and intra-articular steroid injection for adhesive capsulitis are quite beneficial. However the impact of these injections can be short-lived. Experts suggest that a more extensive research is required to study the efficacy of the corticosteroid injections for shoulder pain. There are other issues that also need to be clarified. The most important amongst these is whether the factors like accuracy of needle placement, anatomical site, frequency, dose and type of corticosteroid influences the efficacy of the injection.

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