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

Abstract

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.

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

“…79 Interestingly, the comparison of local wound infiltration (LWI) with peripheral nerve block in hand lacerations did not find any difference in terms of pain and satisfaction scores, but reported a shorter anesthesia onset time for LWI, that makes this technique, easier to perform compared to nerve block, particularly attractive in the emergency department. 81…”

Use of Lidocaine for Pain Management in the Emergency Medicine: A Systematic Review and Meta-Analysis

“…There was a statistically meaningful difference September 2019, 25(3), 177-183 | 181 between patients who had received LIA and PNB, time was longer in patients who received LIA. 4 A study that compared analgesic effect of local or digital block of finger concluded that local administration of lidocaine 1% for wound anaesthesia omitted need for rescue anaesthesia. Pain caused by needle insertion, infiltration of lidocaine and suturing after local anaesthesia or digital block in finger did not differ in the study.…”