Comparison of local infiltration anesthesia and peripheral nerve block:a randomized prospective study in hand lacerations

Background/aim: To compare local infiltration anesthesia (LIA) and peripheral nerve block (PNB) in repairing hand lacerations. Materials and methods: This prospective study was designed as a randomized, controlled, unblinded trial. Fifty four patients with hand lacerations were included in the study. While 23 of these patients had LIA, PNB was performed in the remaining 31 patients. Lidocaine hydrochloride 2% and 27 gauge needles were used. Onset time of the anesthesia, response to the injection and suturing procedures, need for additional anesthetic, and patient satisfaction were compared. Results: No significant differences were noted between the groups in terms of response to injection pain and suture pain (Mann-Whitney U; P = 0.220/P = 0.316). There were also no significant differences between the groups when patient satisfaction (chi-square; P = 0.785) and need for additional local anesthetics (Fisher's exact; P = 0.628) were evaluated. The time to loss of pinprick sensation in the local infiltration group was 1.3 min, whereas in the nerve block group it was 2.2 min. The difference was statistically significant (Mann-Whitney U; P < 0.001). Conclusion: Despite the fact that performing PNB in emergency departments requires some experience, it still counts as a convenient method comparable to LIA.

Comparison of local infiltration anesthesia and peripheral nerve block:a randomized prospective study in hand lacerations

Background/aim: To compare local infiltration anesthesia (LIA) and peripheral nerve block (PNB) in repairing hand lacerations. Materials and methods: This prospective study was designed as a randomized, controlled, unblinded trial. Fifty four patients with hand lacerations were included in the study. While 23 of these patients had LIA, PNB was performed in the remaining 31 patients. Lidocaine hydrochloride 2% and 27 gauge needles were used. Onset time of the anesthesia, response to the injection and suturing procedures, need for additional anesthetic, and patient satisfaction were compared. Results: No significant differences were noted between the groups in terms of response to injection pain and suture pain (Mann-Whitney U; P = 0.220/P = 0.316). There were also no significant differences between the groups when patient satisfaction (chi-square; P = 0.785) and need for additional local anesthetics (Fisher's exact; P = 0.628) were evaluated. The time to loss of pinprick sensation in the local infiltration group was 1.3 min, whereas in the nerve block group it was 2.2 min. The difference was statistically significant (Mann-Whitney U; P < 0.001). Conclusion: Despite the fact that performing PNB in emergency departments requires some experience, it still counts as a convenient method comparable to LIA.

___

  • Hollander JE, Singer AJ. Evaluation of wounds. In: Tintinalli JE, Kelen GD, Stapczynski JS, editors. Emergency Medicine: a Comprehensive Study Guide. 7th ed. New York, NY, USA: McGraw-Hill; 2004. pp. 287–288.
  • Singer AJ, Hollander JE. Lacerations and Acute Wounds: an Evidence-Based Guide. 1st ed. Philadelphia, PA, USA: Davis Company; 2003. pp 9–63.
  • Erdine S. Rejyonel anestezi; Tarihsel perspektif. In: Erdine S, editor. Rejyonel Anestezi. 1st ed. İstanbul, Turkey: Nobel Tıp Kitabevleri; 2008. pp. 1–5.
  • Bruce TA, Bowman JM, Brown ST. Factors that influence patient satisfaction in the emergency department. J Nurs Care Qual 1998; 13: 31–37. 5. Ferrera PC, Chandler R. Anesthesia in the emergency setting: Part I. Hand and foot injuries. Am Fam Physician 1994; 50: 569–573.
  • Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med 2001; 38: 633–638.
  • Hill RG Jr, Patterson JW, Parker JC, Bauer J, Wright E, Heller MB. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Ann Emerg Med 1995; 25: 604–607.
  • Singer AJ, Mach C, Thode HC Jr, Hemachandra S, Shofer FS, Hollander JE. Patient priorities with traumatic lacerations. Am J Emerg Med 2000; 18: 683–686.
  • Lee EJ, Khandwala M, Jones CA. A randomised controlled trial to compare patient satisfaction with two different types of local anaesthesia in ptosis surgery. Orbit 2009; 28: 388–391.
  • Liebmann O,  Price D,  Mills C, Gardner R, Wang R, Wilson S, Gray A. Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med 2006; 48: 558–562.
  • Garibaldi S, Anamarli N. Dorsal cutaneous branch of ulnar nerve. An appraisal on the anatomy, injuries and application of conduction velocity studies in diagnosis. Arch Neuropsiquiatr 2000; 58: 637–641.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

The hematologic manifestations of pediatric celiac disease at the time ofdiagnosis and efficiency of gluten-free diet

Ferat ÇATAL, Erdem TOPAL, Halime ERMİŞTEKİN, Nurdan Yildirim ACAR, Muhammed Selçuk SİNANOĞLU, Hamza KARABİBER, Mukadder Ayşe SELİMOĞLU

Prevention of methotrexate-induced nephrotoxicity by concomitantadministration of garlic aqueous extract in rat

Walaa AHMED, Amr ZAKI, Taghred NABIL

The expression and clinical effects of alpha-methylacyl-CoA racemase (AMACR/ P504S) as an immunohistochemical marker in malign pleural mesothelioma

SEZGİ ŞAHİN DUYAR, AYDIN YILMAZ, FUNDA DEMİRAĞ, YURDANUR ERDOĞAN, ÜLKÜ YAZICI, JALE KARAKAYA

Central corneal thickness in type II diabetes mellitus: is it relatedto the severity of diabetic retinopathy?

Okan TOYGAR, Selçuk SIZMAZ, Aysel PELİT, Baha TOYGAR, Özge Yabaş KIZILOĞLU, Yonca AKOVA

Intrahepatic cholestasis of pregnancy may lead to low birth weight

İbrahim UYAR, İbrahim GÜLHAN, Deniz ÖZTEKİN, Cenk GEZER, Atalay EKİN, Seçil Karaca KURTULMUŞ, Mehmet ÖZEREN

Effect of pioglitazone, quercetin, and hydroxy citric acid on vascular endothelial growth factor messenger RNA (VEGF mRNA) expression in experimentally induced nonalcoholic steatohepatitis (NASH)*

SURAPANENI KRISHNA MOHAN, VISHNU PRIYA VEERARAGHAVAN, MALLIKA JAINU

High-risk febrile neutropenia and its management in childrenwith solid tumors and lymphoma

Doğan KÖSE, Melike EMİROĞLU, Yavuz KÖKSAL

Clinical characteristics of 75 pandemic H1N1 influenza patientsfrom Turkey; risk factors for fatality

HATİCE KILIÇ, ASİYE KANBAY, AYŞEGÜL KARALEZLİ, HATİCE CANAN HASANOĞLU, CAN ATEŞ

Serum Lp-PLA2: as a novel viewpoint in periodontal treatment of hyperlipidaemics

ÖZLEM FENTOĞLU, FATMA YEŞİM KIRZIOĞLU, MEMDUHA TÖZÜM BULUT, ŞİVGE KURGAN, HAVVA KOÇAK, RECEP SÜTCÜ, BANU KALE KÖROĞLU, MERAL GÜNHAN

Correlation between antibiotic resistance and virulence ofPseudomonas aeruginosa clinical isolates

FATMA IBRAHIM SONBOL, MAHA ABD EL FATTAH KHALIL, ABDELFATTAH BADR MOHAMED, SAMEH SAMIR ALI