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A randomized controlled trial to compare two techniques for partial digital local anesthetic blocks.

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A randomized controlled trial to compare two techniques for partial digital local anesthetic blocks.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Whiteley, Bruce Rees, Sharon
Description	Country affiliation: United kingdom Author Affiliation: Whiteley B ( NHS Hounslow Community Healthcare, West Middlesex University Hospital, Isleworth, Middlesex, United Kingdom. bruce.whiteley@hounslowpct.nhs.uk)
Abstract	The administration of local anesthetic before surgery to the great toe is often associated with significant difficulties, delaying surgery and increasing risk. Anxious patients can faint, refuse injection, or withdraw the foot while an anesthetic is being delivered. Such events led us to consider whether delivering a small amount of anesthetic throughout the injection site, before the main injection, may reduce pain intensity and duration. This study was designed to test this possibility. A randomized controlled, single-blinded, parallel-grouped clinical trial was carried out with a sample of 50 patients. All study participants received each injection method (1 or 2 stage) to either the medial or lateral side of the great toe. The primary end points were pain intensity, measured by scores on a visual analogue scale and duration, recorded by the patient with a stopwatch. The 2-stage method was associated with less intense pain (reduced from moderate to mild visual analogue scale level) of a shorter duration. The differences were highly statistically significant. In the 2-stage method, it is believed that they were due to the initial infiltration of a small quantity of the anesthetic solution throughout the injection site, with the remainder being administered, after a 2-minute interval, into tissue that was predominantly anesthetized. This differs from raising a traditional bleb where a small amount of anesthetic is infiltrated into superficial tissue. The 2-stage technique is therefore recommended as the method of choice for adults.
File Format	HTM / HTML
ISSN	10672516
Issue Number	2
Volume Number	49
e-ISSN	15422224
Journal	The Journal of Foot and Ankle Surgery
Language	English
Publisher	Elsevier
Publisher Date	2010-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedics Discipline General Surgery Anesthetics, Local Administration & Dosage Hallux Nerve Block Methods Adult Aged Aged, 80 And Over Female Innervation Humans Injections Male Middle Aged Pain Measurement Single-blind Method Comparative Study Journal Article Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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