Onset Time of Local Anesthesia After Single Injection in Toe Nerve Blocks: A Randomized Double-Blind Trial

Córdoba–Fernández, Antonio; González-Benítez, Jesús; Lobo-Martín, Adrián

doi:10.1016/j.jopan.2018.09.014

Cited by 4 publications

(16 citation statements)

References 17 publications

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“…Seven trials were included for final review. 6,[16][17][18][19][20][21] These studies included 442 DNBs and 363 participants. Mean patient age ranged from approximately 25 to 44 years.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Type of procedure and digit varied by study. Of the seven articles, five reported duration of anesthesia, 16,17,[19][20][21] three reported time taken to onset of anesthesia, 18,20,21 and two reported complications. 6,17 Of those, three reported significant mean differences in duration of anesthesia, 17,19,21 two reported significant differences in onset of anesthesia, 18,20 and none reported worse complications with epinephrine.…”

Section: Description Of Studiesmentioning

confidence: 99%

See 1 more Smart Citation

The Anesthetic Effects of Lidocaine with Epinephrine in Digital Nerve Blocks: A Systematic Review

Arp,

Multani,

Yen

et al. 2023

Journal of the American Podiatric Medical Association

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There is a long-standing stigma associated with the use of epinephrine in digital nerve blocks (DNBs) over the concern of digital necrosis. We conducted a systematic review to assess the duration of anesthesia, onset of anesthesia, and complications of lidocaine with epinephrine compared with plain lidocaine for DNBs in adults. We searched Medline via Ovid, Cochrane Library, and ClinicalTrials.gov on January 28, 2020. We included randomized controlled trials that examined lidocaine with epinephrine 1:80,000 to 1:1,000,000 (1–12.5 µg/mL) and plain lidocaine for DNBs of fingers or toes in adults. We completed a blinded review of all unique articles, followed by full-text reviews, data extraction, and quality assessment of all eligible trials. Risk of bias was assessed to inform qualitative data analysis. We identified seven studies with a combined 363 adults and 442 DNBs that met the inclusion criteria. All five studies that reported duration of anesthesia established longer duration in the epinephrine-supplemented lidocaine group, with significant increases in three. Two of the three studies that reported the onset of anesthesia demonstrated significant differences. The two studies that reported complications did not have a single case of digital necrosis. In adults, the use of lidocaine with epinephrine 1:80,000 to 1:1,000,000 (1–12.5 µg/mL) for DNB yields a longer duration of anesthetic effect and seems to be as safe as plain lidocaine in healthy adults. Several studies had some concern for bias, and additional studies are warranted.

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“…Seven trials were included for final review. 6,[16][17][18][19][20][21] These studies included 442 DNBs and 363 participants. Mean patient age ranged from approximately 25 to 44 years.…”

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

The Anesthetic Effects of Lidocaine with Epinephrine in Digital Nerve Blocks: A Systematic Review

Arp,

Multani,

Yen

et al. 2023

Journal of the American Podiatric Medical Association

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“…The onset time of local anesthesia after single injection was considered clinically significantly reduced when epinephrine was added to lidocaine or bupivacaine, when performing peripheral nerve blocks [34]. Current recommendations, however, allow the use of epinephrine in peripheral blocks only when ultrasonography is not available [35].…”

Section: Epinephrinementioning

confidence: 99%

Local Anesthetics Infiltration and Wound Healing Process

Abrão¹,

Antunes²,

Garcia³

2020

Topics in Local Anesthetics

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It is a good practice, nowadays, to infiltrate local anesthetics along the incision to prevent postoperative pain. This can reduce the use of opioids and the side effects they cause. It is known clearly that the surgical trauma causes inflammatory reaction, and this can be the beginning of a bad cicatrization or even a scar. The use of local anesthetics preventing the acute pain is a very simple technique and has proved to be useful. Nevertheless, the reaction that various anesthetics have over the tissues and the cicatrization process is yet controversial and deserves to be investigated deeply. The use of different formulations of these drugs has been stimulated. The duration and secureness have been the goals of many researches. Levobupivacaine, ropivacaine, and bupivacaine for their long action; lidocaine for less toxicity; and liposomal formulation for the longest duration ever seen, all of them have been indicated in the postoperative pain management. The aim of this chapter is to evaluate the role of long duration local anesthetics on the inflammatory reaction and consequently the collagen production and resistance of the tissue to traction.

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“…Of these, 138 duplicates were excluded and, of the remaining 1,029, 55 papers were chosen based on their titles and compatibility with the inclusion criteria. These papers had their abstracts read, and ten of them were selected for full-text evaluation for eligibility and later included in the qualitative analysis (Table 2) 6,7,[11][12][13][14][15][16][17][18] . However, for the meta-analysis, seven of the ten papers were used.…”

Section: Included Studiesmentioning

confidence: 99%

“…Wilhelmi et al 18 15 , and Sönmez et al 6 . In the study by Cordoba-Fernández et al 14 have evaluated 20 patients divided into two groups (full lidocaine and lidocaine with epinephrine). Their results have shown that SO 2 has significantly been higher after the administration of full lidocaine, at the time in which SO 2 of the group using lidocaine with epinephrine has not had significant difference before and after injection (P=0.017).…”

Section: Need For Bleeding Controlmentioning

confidence: 99%

Efeitos do uso de vasoconstritores no bloqueio de nervos digitais: revisão sistemática com metanálise

Neto

Costa

Veloso

et al. 2019

Rev. Col. Bras. Cir.

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RESUMO Convencionalmente, a associação de anestésicos locais com vasoconstritores é evitada em extremidades pelo risco de isquemia. Entretanto, estudos recentes sugerem haver segurança no uso de vasoconstritor em extremidades. Procuramos, assim, avaliar a efetividade e segurança do uso de vasoconstritores combinados com anestésicos locais no bloqueio de nervos digitais em comparação ao uso de anestésicos plenos, através de uma revisão sistemática com metanálise de ensaios clínicos randomizados. Pesquisamos, até maio de 2019, nas bases de dados MEDLINE, LILACS, SciELO, ScienceDirect, Scopus, ClinicalTrials.gov e literatura cinzenta, sem restrições de data ou idioma, os descritores: bloqueio digital, vasoconstritor e isquemia. Foram incluídos ensaios clínicos randomizados nos quais houve a utilização de anestésicos locais associados ou não a vasoconstritores em bloqueios digitais. Nas variáveis primárias foram analisadas a ocorrência de complicações isquêmicas e a duração da anestesia, e nas variáveis secundárias foram observadas necessidade de reaplicação anestésica, de controle de sangramento e latência. Dez estudos foram incluídos nesta revisão. Não foi observada a ocorrência de isquemia, independente do uso ou não de vasoconstritores. O uso de vasoconstritores na concentração de 1:100.000 ou menor esteve associado a maior duração da anestesia (P<0,00001), menor necessidade de reaplicação anestésica (P=0,02), menor necessidade de controle de sangramento (P=0,00006) e menor latência (P<0,00001). Pudemos concluir que uso de vasoconstritores associados a anestésicos locais no bloqueio digital mostrou-se uma técnica segura e efetiva.

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Onset Time of Local Anesthesia After Single Injection in Toe Nerve Blocks: A Randomized Double-Blind Trial

Cited by 4 publications

References 17 publications

The Anesthetic Effects of Lidocaine with Epinephrine in Digital Nerve Blocks: A Systematic Review

The Anesthetic Effects of Lidocaine with Epinephrine in Digital Nerve Blocks: A Systematic Review

Local Anesthetics Infiltration and Wound Healing Process

Efeitos do uso de vasoconstritores no bloqueio de nervos digitais: revisão sistemática com metanálise

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