Effectiveness of local anesthesia with lidocaine in chronic opium abusers.
BACKGROUND
It had been demonstrated that chronic opium abusers have lower pain thresholds compared with than non-abusers.


OBJECTIVE
This study aimed to compare the required dose of lidocaine, a common local anesthetic drug, with regard to the onset of anesthesia in opium abusers with that in non-abusers undergoing similar suturing of minor hand lacerations.


METHODS
In this study, 109 opium abusers and 91 non-abusers underwent similar suturing for hand lacerations known as digital block. We explained the patients that their case records would remain confidential and admitting to any history of opioid abuse could assist in alleviating any pain associated with the procedure.


RESULTS
There was no statistically significant difference between the two groups with regard to age, gender, and cause of injury (P > 0.05). We found a significantly longer duration of onset of analgesia in nonopioid abusers (5.42 ± 1.93 min) than that in abusers (10.30 ± 1.79 min) (P < 0.001). In addition, the lidocaine dose administered to abusers (6.67 ± 1.21 ml) was higher (4.07 ± 1.26) as well as statistically significant (P < 0.001) than that in non-abusers.


CONCLUSIONS
The findings from this study suggest a longer duration of onset of anesthesia and requirement of a higher lidocaine dose in opium abusers compared with nonopioid abuser. Moreover, chronic opium abusers (4-5 years) experienced significantly higher time of onset of anesthesia compared with nonchronic abusers. This outcome may be useful in selecting a more suitable local anesthetic protocol in such patients.
Department of Emergency, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Amir Masoud
AM
Hashemian
Department of Emergency, Aja University of Medical Sciences, Tehran, Iran.
Ali
A
Omraninava
Department of Medical Surgery Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Darvishpoor
AD
Kakhki
Department of Emergency, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Davood
MD
Sharifi
Department of Emergency, Alborz University of Medical Sciences, Karaj, Iran.
Koorosh
K
Ahmadi
Department of Emergency, Isfahan University of Medical Sciences, Isfahan, Iran.
Babak
B
Masoumi
Department of Clinical Toxicology, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Science, Birjand, Iran.
Omid
O
Mehrpour
Lidocaine; local anesthesia; opium abuse