Use of infiltrative anesthesia in acute anterior dislocation of shoulder

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.