medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2003, Number 5

<< Back Next >>

Acta Ortop Mex 2003; 17 (5)

Intra-articular lidocaine vs intravenous sedation as analgesic method for reduction of the shoulder dislocation

Trueba DC, Pozzo BA, Gil OF

Language: Spanish
References: 11
Page: 225-228
PDF size: 40.54 Kb.


ABSTRACT

Reduction in acute anterior glenohumeral dislocation is an usual procedure in the Emergency Departments and it is performed under intravenous sedation; patients that could not obtain peripheral venous access or sedation was contraindicated was the reason to make this study. We performed a prospective and randomized study, 2 groups of 17 patients were designed, the first group received 20 ml of 1% lidocaine and the other group, intravenous injection of propofol 1 mg/kg. Our results were, in the first group 14 of 17 patients had a successful reduction whereas all 17 of the second group had a successful reduction, time of reduction maneuver and difficulty of reduction were easier and faster in the sedation group but no statistically significant p › 0.05, subjective pain didn’t show difference p ‹ 0.05, time spent in the Emergency Department between both groups showed 47.4 min in the first and 118.4 min in the other p ‹ 0.05, and the costs in both were really different. We consider that intra-articular lidocaine in this type of injuries is a useful and safe method with a low index of complications, it cost less and should be the method of choice when intravenous sedation needs to be avoided.


REFERENCES

  1. Dhinakharan SR, Ghosh A: Towards evidence based emergency medicine: best BETs from the Manchester Royal Infimary. Intra-articular lidocaine for acute anterior shoulder dislocation reduction. Emerg Med J 2002; 19(2): 142-143.

  2. Gumina S, Postacchini F: Anterior dislocations of the shoulder in elderly patients. J Bone Joint Surg Br 1997; 79(4): 540-543.

  3. Kosnik J, Shamsa F, Raphael, E et al: Anesthetic methods for reduction of acute shoulder dislocations: a prospective randomized study comparing intra-articular lidocaine with intravenous analgesia and sedation. Am J Emerg Med 1999; 17(6):566-570.

  4. Matthews DE, Roberts T: Intra-articular lidocaine versus intravenous analgesic for reduction of acute anterior shoulder dislocations. A prospective randomized study. Am J Sports Med 1995; 23(1): 54-58.

  5. Miller SL, Cleeman E, Auerbach J, Flatow EL: Comparison of Intra-articular lidocaine and intravenous sedation for reduction of shoulder dislocations. A randomized, prospective study. J Bone Joint Surg 2002; 84(12): 2135-2139.

  6. Rockwood C, Matsen F: The Shoulder W.B. Saunders Company 1990. Vol. 1, 543-573.

  7. Suder PA, Mikkelsen JB, Hougaard K, et al: Reduction of traumatic secondary shoulder dislocations with lidocaine. Arch Orthop Trauma Surg 1995; 114(4): 233-236.

  8. te Slaa RL, Wijffels MP, Marti RK: Questionnaire reveals variations in the management of acute first time shoulder dislocations in the Netherlands. Eur J Emerg Med 2003; 10(1): 58-61.

  9. Weiker GG, Kuivila TE, Pippinger CE: Serum lidocaine and bupivacaine levels in local technique knee arthroscopy. Am J Sports Med 1991; 19 (5): 499-502.

  10. Yuen MC, Yap PG, Chan YT, Tung WK: An easy method to reduce anterior shoulder dislocation: the Spaso technique. Emerg Med J 2001; 18(5): 370-372.

  11. Yuen MC, Tung WK: The use of Spaso technique in a patient with bilateral dislocations of shoulder. Am J Emerg Med 2001; 19(1): 64-66.




2020     |     www.medigraphic.com