Post-injection Sciatic Neuropathy: A five-year review of cases managed in a paediatric hospital in Ibadan, Nigeria

Abstract

The World Health Organization (WHO) reported that the administration of injections is one of the most common healthcare procedures, and unsafe injections are associated with morbidity and mortality, especially in developing countries. Post-injection sciatic neuropathy (PISN) has been identified as a serious complication of gluteal intramuscular (IM) injections. The long-term care of PISN poses an economic burden on carers and increases physiotherapists’ burden of care.
This study reviewed two hundred and ten cases of PISN among eight hundred paediatric cases seen from January 2004 to December 2008 in the Physiotherapy Clinic of Oni Memorial Children’s Hospital in Ibadan, Nigeria. Each patient was evaluated for the limb affected, the health care centre where the injection was given and the health care personnel who gave the injection.
One hundred and twenty three (58.6%) of the patients were male while eighty seven (41.4%) were female. A majority of the injections were administered at private hospitals – 143 (68.1%). The others were at general hospitals 22 (11.2%), by ‘nurses’ at dispensing shops 17 (8.1%) , at primary healthcare centres 12 (5.7%) , and two (1%) were given at home by the children’s grandmothers.
Since PISN is a preventable condition, there is a need to minimize gluteal IM injections especially when other routes such as the vastus lateralis muscle can be used. A majority of the children with PISN (84.7%) were below the age of five and this makes it imperative for caution to be exercised when gluteal IM injections are given to this age group. Update and refresher courses should be regularly organized for the health professionals concerned, to minimize the occurrence of PISN.

KEY WORDS: post-injection, sciatic neuropathy, paediatric, intramuscular