Dilution of a mepivacaine-adrenaline solution in isotonic sodium bicarbonate for reducing subcutaneous infiltration pain in ambulatory phlebectomy procedures: A randomized, double-blind, controlled trial - 16/10/14
, Stefano Ricci, MD, Gloria Abbruzzese, MD, Raffaele Antonelli-Incalzi, MDAbstract |
Background |
Varicose veins are treated under local infiltration anesthesia. Literature shows that adding sodium bicarbonate reduces the pain associated with local infiltration anesthesia. Nonetheless, sodium bicarbonate is underused.
Objective |
We sought to assess if the use of a solution of mepivacaine 2% plus adrenaline with sodium bicarbonate 1.4% results in less pain associated with local infiltration anesthesia preceding ambulatory phlebectomies, compared with standard preparation diluted with normal saline.
Methods |
In all, 100 adult patients undergoing scheduled ambulatory phlebectomy were randomized to receive either a solution of mepivacaine chlorhydrate 2% plus adrenaline in sodium bicarbonate 1.4% or a similar solution diluted in normal saline 0.9%.
Results |
Median pain scores associated with local infiltration anesthesia reported in the intervention and control groups were 2 (SD = 1.6) and 5 (SD = 2.0) (P < .0001), respectively. A general linear model with bootstrapped confidence intervals showed that using the alkalinized solution would lead to a reduction in pain rating of about 3 points.
Limitations |
Patients were not asked to distinguish the pain of the needle stick from the pain of the infiltration. Moreover, a complete clinical study of sensitivity on the infiltrated area was not conducted.
Conclusions |
Data obtained from this study may contribute to improve local infiltration anesthesia in ambulatory phlebectomy and other phlebologic procedures.
Le texte complet de cet article est disponible en PDF.Key words : alkalinized anesthesia, local infiltration anesthesia, phlebectomy, phlebology, reticular veins, varicose veins
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
Vol 71 - N° 5
P. 960-963 - novembre 2014 Retour au numéro
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