Long- or short-acting anesthetic with corticosteroid in local injections of overuse injuries? A prospective, randomized, double-blind study.
A prospective, randomized, double-blind study of 56 patients presenting with an overuse sports injury was undertaken in order to compare the effect of a long-acting anesthetic (bupivacaine) with a short-acting anesthetic (lidocaine) in local corticosteroid injections. At presentation, patients were either administered a periarticular injection of 2 ml of methyl prednisolone acetate with bupivacaine (MPA-B) (40 mgs per ml + 5 mgs per ml) or 2 ml of MPA with lidocaine (MPA-L) (40 mgs per ml + 10 mgs per ml). No other treatment was given. Results indicated that pain inhibition was better in the MPA-B group during the first six hours after the injection, obviously because of the longer half-life of bupivacaine. In later evaluations no differences could be observed: in both groups pain disappeared partly or completely in two-thirds of the patients and full recovery to sports was possible in half of them. Long-acting bupivacaine is recommended as an anesthetic substance in local steroid injections of musculoskeletal overuse injuries.
Kannus
P
P
Tampere Research Station of Sports Medicine, Finland.
Järvinen
M
M
Niittymäki
S
S
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000188:drug therapy*; D002045:Bupivacaine / Q000627:therapeutic use*; D012090:Cumulative Trauma Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D007270:Injections, Intra-Articular; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D011446:Prospective Studies
D008012:Lidocaine; D008775:Methylprednisolone; D002045:Bupivacaine