Evidenced-based local anaesthesia-is there a difference in practice between specialties in a major trauma centre?

Muscat, EPJ; Ali, S; Berner, JE

Journal article

Evidenced-based local anaesthesia-is there a difference in practice between specialties in a major trauma centre?

Abstract:: Background Local anaesthesia (LA) is used widely in several clinical scenarios in hospital practice. A number of minor trauma wounds are treated under LA at the North Bristol Trust, and on most occasions, these patients are admitted to the emergency department (ED) and treated there. On other occasions, more complex wounds may be treated by the plastic surgery team. The aim of this study is to compare the preferences of LA agents between these departments in cases of minor trauma. The authors also present a narrative review of the literature and determine best practice. Methods A single-centre clinical practice survey was developed and distributed to both departments which involved two case scenarios, one involving a head injury to the occiput (scenario 1) and one nailed repair (scenario 2) both requiring treatment under LA. Results In both scenarios ED favoured lidocaine (89%) whereas the plastic surgery team preferred to mix solutions. In scenario 1, 89% of ED participants chose lidocaine 1%, but only 38% of the plastic surgery team chose it. Forty-two percent of ED chose to use adrenaline but 100% plastic surgery team chose it. Both teams refrained from using adrenaline in digits, but 23% of the plastic surgery team chose it. Eighty-four percent of ED chose 25G needles, and the plastic surgery team’s choices varied. Conclusions This study has shown marked differences in the use of LA between two specialties in a major trauma centre. There is good quality evidence to support the safety of adrenaline use in digits with the addition of sodium bicarbonate to decrease the pain inflicted to the patient upon infiltration of LA. This study serves to raise awareness of the surgical dogma around adrenaline use and provide clinicians with an evidence-based guide to managing minor trauma with LA. Level of evidence: Not ratable.

Publication status:: Published

Peer review status:: Peer reviewed

Actions

Email

Email this record

Send the bibliographic details of this record to your email address.

Your Email
Please enter the email address that the record information will be sent to.

-
Your message (optional)
Please add any additional information to be included within the email.
Cite

Cite this record

APA Style

Muscat, E. P. J., Ali, S., & Berner, J. E. (2021). Evidenced-based local anaesthesia-is there a difference in practice between specialties in a major trauma centre? European Journal of Plastic Surgery, 44(4), 511–516.

MLA Style

Muscat, E. PJ, et al. “Evidenced-Based Local Anaesthesia-Is There a Difference in Practice between Specialties in a Major Trauma Centre?” European Journal of Plastic Surgery, vol. 44, no. 4, Springer, 2021, pp. 511–16.

Chicago Style

Muscat, EPJ, S Ali, and JE Berner. 2021. “Evidenced-Based Local Anaesthesia-Is There a Difference in Practice between Specialties in a Major Trauma Centre?” European Journal of Plastic Surgery 44 (4): 511–16.
Share
Print