Evaluation of the Result of the Addition of Sodium Bicarbonate in a Solution for Infiltration in Hand Pathologies
DOI:
https://doi.org/10.21270/archi.v12i11.6210Keywords:
De Quervain Disease, Trigger Finger Disorder, Synovial Cyst, Anesthesia, Local, HandAbstract
Introduction: Injections with corticosteroids are used to manage various hand pathologies. The previous anesthetic injection can be performed for painless infiltration, but the anesthetic injection causes pain due to the difference between the anesthetic and physiological pH. Therefore, anesthetic tamponade can be performed for symptomatic relief. This study assesses whether the buffered solution alleviates pain during anesthetic infiltration. Methods: The study is prospective, experimental case type, in which 16 infiltrations with sodium bicarbonate and 16 without this substance were performed at the wrist and hand level to evaluate the pain response of the patient, a participant in the research. Results: Pain during infiltration was not associated with the solution used (F(1.24)=0.26; p=0.61), nor with gender (F(1.24)=1.34; p=0 .26), the type of pathology (F(2.24)=2.46; p=0.11), the level of fear before the infiltration (F(1.24)=0.22; p=0, 64), the previous performance of infiltration (F(1,24)=0.06; p=0.81) or the presence of previous comorbidity (F(1,24)=0.12; p=0.74). Conclusion: This study did not show enough evidence to recommend routinely buffering the anesthetic solution with sodium bicarbonate. In this sense, new studies should be carried out with a broader sample to corroborate previous studies, which indicate the performance of such a procedure.measured their ability to improve their knowledge, especially when it comes to promoting periodontal health, goals reached in the current project.
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References
Pardini AG, Freitas AD. Cirurgia de Mão: Lesões Não-Traumáticas. 2. ed. Rio de Janeiro: MEDBOOK; 2008
Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. 12th. Philadelphia: Elsevier Inc; 2013
Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green’s Operative Hand Surgery. 8th ed. Philadelphia: Elsevier, Inc; 2022
Pardini Jr. AG, Freitas AD, Gusmão Filho NS. História natural do quisto sinovial do dorso do punho. Rev Bras Ortop 1998;33(3):199-202
Rozental TD, Zurakowski D, Blazar PE. Trigger finger: Prognostic indicators of recurrence following corticosteroid injection. J Bone Joint Surg Am 2008;90(8):1665-1672
Marica LS, O'Day T, Janosky JE, Nystrom EU. Chloroprocaine is less painful than lidocaine for skin infiltration anesthesia. Anesth Analg 2002;94(2):351-354
Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora GandhiP, Schumann R. Ajustando o pH da lidocaína para reduzir a dor à injeção. Coc, p. 1-3, 2010
Frank SG, Lalonde DH. How acidic is the lidocaine we are injecting, and how much bicarbonate should we add? Can J Plast Surg 2012;20(2):71-73
Palozzo M. The Perceived Fear Scale. 2014. Available from: https://www.marcellopalozzo.com/the-perceived-fear-scale/
Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain 2011;152(10):2399-2404
Hashmi JA, Davis KD. Deconstructing sex differences in pain sensitivity. Pain 2014;155(1):10-13
R. The R Project for Statistical Computing (versão 4.1.2). R Foundation for Statistical Computing, Vienna. 2021 [Cited 2021, Jan 5]. Available from: https://www.R-project.org
Fox J, Weisberg S. An R Companion to Applied Regression. 3rd Edition. Thousand Oaks: SAGE Publications, Inc; 2019
GraphPad Prism. GraphPad Software. San Diego. 2023 [cited 2023, Jan 5]. Available from: www.graphpad.com
Akhtar S, Burke FD. Study to outline the efficacy and illustrate techniques for steroid injection for trigger finger and thumb. Postgrad Med J 2006;82(973):763-766
Lunsford D, Valdes K, Hengy S. Conservative management of trigger finger: A systematic review. J Hand Ther 2019;32(2):212-221
Schubert C, Hui-Chou HG, See AP, Deune EG. Corticosteroid injection therapy for trigger finger or thumb: A retrospective review of 577 digits. Hand (NY) 2013;8(4):439-444
Fahey JJ, Bollinger JA. Trigger-finger in adults and children. J Bone Joint Surg Am 1954;36-A(6): 1200-1218
Moore JS. Flexor tendon entrapment of the digits (trigger finger and trigger thumb). J Occup Environ Med 2000;42(5):526-545
Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Reum 2004;51(4):642-651
Goel R, Abzug JM. de Quervain’s tenosynovitis: a review of the rehabilitative options. Hand (NY) 2015;10(1):1-5
Lane LB, Boretz RS, Stuchin SA. Treatment of de Quervain’s disease: role of conservative management. J Hand Surg Br 2001;26(3):258-260
Head L, Gencarelli JR, Allen M, Boyd KU. Wrist ganglion treatment: Systematic review and meta-analysis. J Hand Surg Am 2015;40(3):546-53.e8
Suen M, Fung B, Lung CP. Treatment of Ganglion Cysts. ISRN Orthop 2013;2013(1):1-7. Published 2013 May 28.
Vossinakis IC, Stavroulaki P, Paleochorlidis I, Badras LS. Reducing the pain associated with local anaesthetic infiltration for open carpal tunnel decompression. J Hand Surg Br 2004;29(4):399-401
Lee HJ, Cho YJ, Gong HS, Rhee SH, Park HS, Baek GH. The effect of buffered lidocaine in local anesthesia: A prospective, randomized, double-blind study. J Hand Surg Am 2013;38(5):971-975
Fillingim RB. Individual differences in pain: Understanding the mosaic that makes pain personal. Pain 2017;158(4):S11-S18
Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The Biopsychosocial Approach to Chronic Pain: scientific advances and future directions. Psychol Bull 2007;133(4):581-624
Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: Which to use? Am J Emerg Med 2018;36(4):707-714.