Comparative study of intra-articular lidocaine and intravenous conscious sedation for shoulder dislocations

Abstract

Background : Acute anterior shoulder dislocation is the most common large joint dislocation. Currently, intravenous sedation(IVS) analgesia is commonly applied before reduction in emergency department, then closely observe for drugs complications which time consumed and leads to patients delay management as a result of medical staff scarceness. Intra-articular Lidocaine(IAL) injection is safe, effective, and less time consumed. It might be the one of good alternative for this group of patients.

Objective : To compare the treatment time required for shoulder dislocations between intra-articular Lidocaine injection and intravenous conscious sedation before reduction.

Materials and Methods : This Prospective randomized controlled trial was carried out of acute shoulder dislocation patients in Yasothon Hospital from 1st August 2019 to 30th April 2020. Analytic statistics were Chi square and Fisher’s Exact probability test, for continuous variables using independent student t-test and statistically significant at P-value <0.05.

Results : Totally 30 patients with acute shoulder dislocation were included, 15 patients in both IAL and IVS group. Patients with IAL had shorter time to discharge and less complications with statistically significant (p value <0.001 and 0.017 respectively). There was no statistically significant in success rate, pain score, reduction time (p value 0.598, 0.304, 0.147 respectively)

Conclusions : The use of intra-articular Lidocaine injection for reduction of shoulder dislocation is time saving in emergency department, less complications and as effective as intravenous conscious sedation. So it seems to be a good analgesic option before reduce shoulder dislocation.