open access

Vol 6, No 2 (2021)
Research paper
Published online: 2021-05-31
Get Citation

Use of infiltrative anesthesia in acute anterior dislocation of shoulder

Murat Koken, Ahmet Hakan Kara, Cem Guneri, Berk Guclu
DOI: 10.5603/DEMJ.a2021.0010
·
Disaster Emerg Med J 2021;6(2):70-74.

open access

Vol 6, No 2 (2021)
ORIGINAL ARTICLES
Published online: 2021-05-31

Abstract

BACKGROUND: To evaluate the results of infiltrative anesthesia for manual closed reduction of acute primary anterior shoulder dislocation.   MATERIAL AND METHODS: A total of 55 adults with acute anterior dislocation of shoulder who were treated with Hippocratic maneuver were evaluated. Infiltrative anesthesia was applied directly to the deltoid muscle from two anatomic locations in anterolateral and posterolateral of the shoulder with prilocaine hydrochloride and bupivacaine (Citanest® + Marcaine®) was applied to all patients. All patients’ reductions were made by the same orthopaedic surgeon. Visual Analog Scale (VAS) of pain was applied to all subjects for evaluating the pain in management after the treatment. Demographic and clinical data, time of duration for reduction, and duration of hospitalization were recorded.   RESULTS: Mean age was 57.9 ± 4.5 years, 22% were women. The reduction was completed with the mean duration of 1.0 ± 0.3 minutes after applying infiltrative anesthesia. The mean VAS scores of the patients used infiltrative anesthesia were 4.6 which indicated moderate pain. The treatment was completed in the emergency room so that patients could be discharged after reduction in the emergency department. No recurrence and complications were observed in the one-year follow-up period.   CONCLUSION: Our study showed that infiltrative anesthesia, in addition to its easy management by orthopaedic surgeons, allows successful and fast reduction by avoiding difficulties caused by the contraction of the deltoid muscle without necessitating sedoanalgesia or general anesthesia.

Abstract

BACKGROUND: To evaluate the results of infiltrative anesthesia for manual closed reduction of acute primary anterior shoulder dislocation.   MATERIAL AND METHODS: A total of 55 adults with acute anterior dislocation of shoulder who were treated with Hippocratic maneuver were evaluated. Infiltrative anesthesia was applied directly to the deltoid muscle from two anatomic locations in anterolateral and posterolateral of the shoulder with prilocaine hydrochloride and bupivacaine (Citanest® + Marcaine®) was applied to all patients. All patients’ reductions were made by the same orthopaedic surgeon. Visual Analog Scale (VAS) of pain was applied to all subjects for evaluating the pain in management after the treatment. Demographic and clinical data, time of duration for reduction, and duration of hospitalization were recorded.   RESULTS: Mean age was 57.9 ± 4.5 years, 22% were women. The reduction was completed with the mean duration of 1.0 ± 0.3 minutes after applying infiltrative anesthesia. The mean VAS scores of the patients used infiltrative anesthesia were 4.6 which indicated moderate pain. The treatment was completed in the emergency room so that patients could be discharged after reduction in the emergency department. No recurrence and complications were observed in the one-year follow-up period.   CONCLUSION: Our study showed that infiltrative anesthesia, in addition to its easy management by orthopaedic surgeons, allows successful and fast reduction by avoiding difficulties caused by the contraction of the deltoid muscle without necessitating sedoanalgesia or general anesthesia.

Get Citation

Keywords

acute, shoulder dislocation, infiltrative anesthesia, emergency

About this article
Title

Use of infiltrative anesthesia in acute anterior dislocation of shoulder

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 6, No 2 (2021)

Article type

Research paper

Pages

70-74

Published online

2021-05-31

DOI

10.5603/DEMJ.a2021.0010

Bibliographic record

Disaster Emerg Med J 2021;6(2):70-74.

Keywords

acute
shoulder dislocation
infiltrative anesthesia
emergency

Authors

Murat Koken
Ahmet Hakan Kara
Cem Guneri
Berk Guclu

References (24)
  1. Dala-Ali B, Penna M, McConnell J, et al. Management of acute anterior shoulder dislocation. Br J Sports Med. 2014; 48(16): 1209–1215.
  2. Krøner K, Lind T, Jensen J. The epidemiology of shoulder dislocations. Archives of Orthopaedic and Trauma Surgery. 1989; 108(5): 288–290.
  3. Goss T. Anterior Glenohumeral Instability. Orthopedics. 1988; 11(1): 87–95.
  4. Kosnik J, Shamsa F, Raphael E, et al. Anesthetic methods for reduction of acute shoulder dislocations: a prospective randomized study comparing intraarticular lidocaine with intravenous analgesia and sedation. Am J Emerg Med. 1999; 17(6): 566–570.
  5. Chung J. The effectiveness of a specially designed shoulder chair for closed reduction of acute shoulder dislocation in the emergency department. http://isrctn.org/>. .
  6. Matthews D, Roberts T. INTRA-ARTICULAR LIDOCAINE VERSUS INTRAVENOUS ANALGESIA FOR REDUCTION OF ACUTE ANTERIOR SHOULDER DISLOCATIONS. Southern Medical Journal. 1993; 86(Supplement): 85.
  7. McKenzie PJ, Loach AB. Local anaesthesia for orthopaedic surgery. Br J Anaesth. 1986; 58(7): 779–789.
  8. Aranda M. Pain Management and Regional Anesthesia in Trauma. Regional Anesthesia and Pain Medicine. 2000; 25(3): 334.
  9. Chelly JE, Gebhard R, Greger J, et al. Regional anesthesia for outpatient orthopedic surgery. Minerva Anestesiol. 2001; 67(9 Suppl 1): 227–232.
  10. Weinstein EJ, Levene JL, Cohen MS, et al. Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. Cochrane Database Syst Rev. 2018; 4: CD007105.
  11. Alkaduhimi H, van der Linde JA, Flipsen M, et al. A systematic and technical guide on how to reduce a shoulder dislocation. Turk J Emerg Med. 2016; 16(4): 155–168.
  12. Jiang N, Hu Yj, Zhang Kr, et al. Intra-articular lidocaine versus intravenous analgesia and sedation for manual closed reduction of acute anterior shoulder dislocation: an updated meta-analysis. J Clin Anesth. 2014; 26(5): 350–359.
  13. Doral M, Doral M, Turhan E, et al. Endoscopy and Percutaneous Suturing in the Achilles Tendon Ruptures. Sports Injuries. 2011: 917–923.
  14. Reynolds F. Maximum Recommended Doses of Local Anesthetics. Regional Anesthesia and Pain Medicine. 2005; 30(3): 314–316.
  15. Yaray O, Akesen B, Ocaklioğlu G, et al. Validation of the Turkish version of the visual analog scale spine score in patients with spinal fractures. Acta Orthop Traumatol Turc. 2011; 45(5): 353–358.
  16. Moharari RS, Khademhosseini P, Espandar R, et al. Intra-articular lidocaine versus intravenous meperidine/diazepam in anterior shoulder dislocation: a randomised clinical trial. Emerg Med J. 2008; 25(5): 262–264.
  17. Orlinsky M, Shon S, Chiang C, et al. Comparative study of intra-articular lidocaine and intravenous meperidine/diazepam for shoulder dislocations. J Emerg Med. 2002; 22(3): 241–245.
  18. Fitch RW, Kuhn JE. Intraarticular lidocaine versus intravenous procedural sedation with narcotics and benzodiazepines for reduction of the dislocated shoulder: a systematic review. Acad Emerg Med. 2008; 15(8): 703–708.
  19. Cheok CY, Mohamad JA, Ahmad TS. Pain relief for reduction of acute anterior shoulder dislocations: a prospective randomized study comparing intravenous sedation with intra-articular lidocaine. J Orthop Trauma. 2011; 25(1): 5–10.
  20. Hames H, McLeod S, Millard W. Intra-articular lidocaine versus intravenous sedation for the reduction of anterior shoulder dislocations in the emergency department. CJEM. 2011; 13(6): 378–383.
  21. Dunn MJG, Mitchell R, Souza CD, et al. Evaluation of propofol and remifentanil for intravenous sedation for reducing shoulder dislocations in the emergency department. Emerg Med J. 2006; 23(1): 57–58.
  22. Hames H, McLeod S, Millard W. Intra-articular lidocaine versus intravenous sedation for the reduction of anterior shoulder dislocations in the emergency department. CJEM. 2011; 13(6): 378–383.
  23. Dunn MJG, Mitchell R, Souza CD, et al. Evaluation of propofol and remifentanil for intravenous sedation for reducing shoulder dislocations in the emergency department. Emerg Med J. 2006; 23(1): 57–58.
  24. Miller SL, Cleeman E, Auerbach J, et al. Comparison of intra-articular lidocaine and intravenous sedation for reduction of shoulder dislocations: a randomized, prospective study. J Bone Joint Surg Am. 2002; 84(12): 2135–2139.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl