Long-term safety of using local anesthetic injections in professional rugby league.
BACKGROUND
Local anesthetic pain-killing injections are commonly used by some professional football teams to allow continued play for certain injuries; however, the long-term safety of this practice has not been studied.


OBJECTIVE
The majority of local anesthetic injections administered in professional football are helpful and safe, not leading to long-term sequelae.


METHODS
Case series; Level of evidence, 4.


METHODS
A retrospective survey was conducted of 100 players over 10 seasons who had been injected with local anesthetic on 1023 occasions for 307 injuries (81% follow-up; average follow-up, 5 years; minimum, 1 year). A comparison of match performance statistics was made from 3 seasons between players using and not using local anesthetic.


RESULTS
The majority (98%) of players would repeat the procedure if they had their injury again, although 32% felt that there were side effects associated with the procedure (including 22% who thought that the recovery of the primary injury was delayed and 6% who thought that the injury was worsened by playing with local anesthetic). On long-term follow-up, only 6% of players had significant residual pain in the body part injected. The satisfaction rates for acromioclavicular injuries, finger injuries, rib injuries, and iliac contusions were higher than for sternum injuries, wrist injuries, and ankle injuries. Player performance between those players injected and not injected with local anesthetic was not substantially different and mainly reflected a positional bias for the players who used local anesthetic.


CONCLUSIONS
The most commonly injected injuries-acromioclavicular joint sprains, finger and rib injuries, and iliac crest contusions-appear to be quite safe (in the context of professional sport) to inject at long-term follow-up. Conversely, ankle, wrist, and sternum injections appear to be less safe. A few injuries may have been substantially worsened by playing after an injection.
Orchard
John W
JW
Sydney School of Public Health, University of Sydney, Sydney, New South Wales 2006, Australia. johnworchard@gmail.com
Steet
Elizabeth
E
Massey
Andrew
A
Dan
Sommit
S
Gardiner
Ben
B
Ibrahim
Ameer
A
D000328:Adult; D000772:Anesthesia, Local / Q000009:adverse effects*; D001265:Athletic Injuries / Q000188:drug therapy*; D015331:Cohort Studies; D003625:Data Collection; D064420:Drug-Related Side Effects and Adverse Reactions; D005538:Football / Q000293:injuries*; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D012272:Ribs / Q000293:injuries; D012307:Risk Factors; D013180:Sprains and Strains / Q000188:drug therapy; D011795:Surveys and Questionnaires; D013997:Time Factors