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

Authors: ALP ŞENER, AHMET DEMİRCAN, AYFER KELEŞ, FİKRET BİLDİK, KANBER KARAKURT

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.

Keywords: Peripheral nerve block, local infiltration anesthesia, hand lacerations, pain, satisfaction

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