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

In vitro efficacy of frozen erythrocytes: implementation of new strategicblood stores to alleviate resource shortage (issue revisited)

Riza Aytaç ÇETİNKAYA, Soner YILMAZ, İBRAHİM EKER, AYTEKİN ÜNLÜ, METİN UYANIK, Serkan TAPAN, AHMET PEKOĞLU, ALİYE AYSEL PEKEL, Zerrin ERTAŞ, Orhan GÜRSEL, Uğur Haci MUŞABAK, Sebahattin YILMAZ, İSMAİL YAŞAR AVCI, AHMET TÜRKER ÇETİN, CAN POLAT EYİGÜN

Differences in the effectiveness of serum biomarkers for the diagnosis of bacterial infections in adult and elderly patients admitted to the emergency department

HAVA YILMAZ, LATİF DURAN, KERAMETTİN YANIK, MEHMET ALTUNTAŞ, MUSTAFA SÜNBÜL

Serologic testing for celiac disease in young people with elevated transaminases

Juanli YUAN, Jinyan GAO, Yonghong YAO, Hongbing CHEN

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

Doğan KÖSE, Melike EMİROĞLU, Yavuz KÖKSAL

Toxic potentials of ten herbs commonly used for aphrodisiac effect in Turkey

Mahmoud ABUDAYYAK, Ebru Özdemir NATH, Gül ÖZHAN

Effects of prenatally exposed diclofenac sodium on rat heart tissue:a stereological and histological study

Fikret GEVREK, Mikail KARA, Murat Çetin RAĞBETLİ, Hüseyin ASLAN

Correlation between serum levels of vitamin B12 and anti-Helicobacter pyloriIgA antibodies in vitamin B12 deficient Palestinian patients

RASMI ABU HILU, OSAMA DUDEEN, SAMEER ABDULLATIF BARGHOUTHI

Distribution and antifungal resistance of Candida speciesisolated from intensive care units

Pinar KORKMAZ, Yeşim ALPAY, Figen ÇEVİK, Nevil AYKIN, Ayşe KOYGUN, Hakki Mustafa GÜLDÜREN

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

Prospective investigation of the hypothalamo?pituitary?adrenalaxis in patients with tularemia

HAYATİ DEMİRASLAN, YASİN ŞİMŞEK, FATİH TANRIVERDİ, MEHMET DOĞANAY, HASAN FAHRETTİN KELEŞTEMUR