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Injection-induced sciatic nerve injury in Nigerian children
1Department of Paediatrics, University College Hospital, Ibadan, Nigeria. fat@skannet.com
Insights
Intramuscular injections in children, especially those under five, can lead to sciatic nerve injury. Avoiding this route and using trained personnel can prevent such injuries.
Area of Science:
- Pediatric Medicine
- Neurology
- Public Health
Background:
- Sciatic nerve injury is a potential complication of medical procedures in children.
- Intramuscular injections, particularly in the buttock, have been implicated in pediatric sciatic nerve injuries.
Purpose of the Study:
- To determine predisposing factors for sciatic nerve injury in children.
- To highlight practical preventive measures for sciatic nerve injury in pediatric patients.
Main Methods:
- Retrospective study of pediatric sciatic nerve injury cases.
- Data collected from case files at University College Hospital, Ibadan, Nigeria (1988-1999).
Main Results:
- 27 children diagnosed with sciatic nerve injury; 74% were five years or younger.
- Most patients (74%) presented late with foot drop after buttock intramuscular injections.
- Injections were often administered in private facilities by minimally trained staff.
Conclusions:
- Strongly discourage the intramuscular route for injections when alternatives exist.
- Ensure only trained healthcare professionals administer intramuscular injections.
- Consider alternative injection sites to the buttock in children, especially those under five, to prevent sciatic nerve injury.
Objectives:
A retrospective study of all children with a diagnosis of sciatic nerve injury managed at the University College Hospital, Ibadan, Nigeria over a 12 year period was carried out in order to determine predisposing factors to the nerve injury and highlighting practical preventive measures.
Design:
The necessary data was collected from the case files of children seen at the hospital with a diagnosis of sciatic nerve injury, from 1988 to 1999.
Results:
There were 27 children aged five months to 12 years with a diagnosis of sciatic nerve injury. Twenty (74%) of the children were aged five years or less. While seven patients (26%) presented within two weeks of development of foot drop consequent on intramuscular (i.m.) injection given on the buttock, 20 patients (74%) presented much later. Fever was the most common complaint for which the injection had been given. The identity of the drugs given was not known in 10 patients. In the remaining 17 patients drugs administered were specified and included Chloroquine, Novalgin, Paraldehyde, Procaine penicillin, and Sulfadoxine-Pyrimethamine. Most of the patients had received the injections in privately owned medical facilities where staff with minimal training are often allowed to administer i.m. injections.
Conclusion:
It is suggested that the i.m. route for injection be strongly discouraged when a drug can be given by other routes. Only trained staff should be allowed to administer i.m. injections. Giving i.m. injections at sites other than the buttock maybe advantageous in children particularly those aged five years and below.
