Shoulder Subacromial Injection Periprocedural Care

Updated: Feb 16, 2021
  • Author: Brett J Rothaermel, MD, PT; Chief Editor: Erik D Schraga, MD  more...
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Periprocedural Care

Patient Education and Consent

Before the procedure, the risks, benefits, and alternatives should be discussed with the patient. Informed consent should be obtained.



Equipment employed for subacromial injection includes the following:

  • Sterile gloves
  • Bactericidal skin preparation solution
  • Needle, 1.5 in., 22-25 gauge
  • Syringe, 10 mL
  • Lidocaine 1% without epinephrine (or similar local anesthetic), 5 mL
  • Sterile gauze
  • Sterile adhesive

Additional equipment for either indirect or direct ultrasound-guided injections includes the following:

  • Ultrasound device with 7.5-15 MHz linear-array broadband probe 
  • Sterile (direct approach) or nonsterile (indirect skin-marking approach) ultrasound gel

Patient Preparation


Cooling spray or local anesthetic may be used. If a local anesthetic is chosen, use a separate 25-gauge needle to raise a wheal at the site of the injection by inserting the needle about 1 cm below the skin surface. (See Local Anesthetic Agents, Infiltrative Administration.)


The patient should be seated upright in a comfortable position with the arm hanging unsupported by the patient's side.