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BJA Advance Access originally published online on December 9, 2005
British Journal of Anaesthesia 2006 96(2):259-261; doi:10.1093/bja/aei292
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

REGIONAL ANAESTHESIA

Intra-articular injection of warmed lidocaine improves intraoperative anaesthetic and postoperative analgesic conditions

Y.-C. P. Arai1,*, M. Ikeuchi2, K. Fukunaga1, W. Ueda3, T. Kimura4 and T. Komatsu5

1 Department of Anaesthesiology, Kochi Medical School, 2 Department of Orthopaedics, Kochi Medical School and 3 Department of Anaesthesiology, Clinical Physiology and Pharmacology, School of Nursing, Kochi Medical School, Oko-Cho, Nankoku City, Kochi, Japan. 4 Multidisciplinary Pain Centre, Aichi Medical University, School of Medicine and 5 Department of Anaesthesiology, Aichi Medical University, School of Medicine, 21 Karimata, Nagakutecho, Aichigun, Aichi, 480-1195, Japan

* Corresponding author: Multidisciplinary Pain Centre, Aichi Medical University, School of Medicine, 21 Karimata, Nagakutecho, Aichigun, Aichi, 480-1195, Japan. E-mail: arainon{at}aichi-med-u.ac.jp

Background. Although local anaesthesia for knee arthroscopy is a well-documented procedure, arthroscopy under local anaesthesia is often interrupted because of intolerable discomfort and pain. Warming local anaesthetic solutions may increase its anaesthetic effect. We tested whether intra-articular injection of warmed lidocaine solution could improve intraoperative anaesthetic and postoperative analgesic conditions.

Methods. Patients in the warmed group received 20 ml warmed (40°C) lidocaine 1% intra-articularly 20 min before surgery. The patients in the control group received 20 ml room-temperature (25°C) lidocaine 1% intra-articularly 20 min before surgery. During surgery, the patients reported pain on a visual analogue scale (VAS).

Results. The median VAS pain score was 1.5 (range, 0.0–3.0) in the warmed lidocaine group and 5.0 (4.0–8.0) in the control group (P<0.001). The median intra- and postoperative analgesic requirements in the control group were significantly greater than that in the warmed group.

Conclusion. Warmed lidocaine injected intra-articularly provides improved intraoperative anaesthetic and postoperative analgesic conditions for patients undergoing knee arthroscopy.


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E-letters:

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How to warm lignocaine?
Amar Karmarkar, et al.
British Journal of Anaesthesia, 15 Feb 2006 [Full text]
Re: How to warm lignocaine?
Young-Chang P. Arai Arai
British Journal of Anaesthesia, 16 Feb 2006 [Full text]

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