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A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients

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Transdermal anaesthesia for percutaneous trigger finger release.

Christos K Yiannakopoulos¹, Ioannis A Ignatiadis

¹Laboratory for the Research of the Musculoskeletal System, University of Athens, Athens, Greece. cky@ath.forthnet.gr

Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand

|April 4, 2007

Summary

Transdermal anaesthesia with eutectic mixture of lidocaine and prilocaine (EMLA) offers a pain-free alternative to injectable lidocaine for percutaneous trigger finger release. This method significantly reduces pain during anaesthesia administration, ensuring patient comfort and procedure success.

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Area of Science:

Orthopedic Surgery
Pain Management
Dermatology

Background:

Trigger finger syndrome, or stenosing tenosynovitis, is a common condition affecting the hand.
Percutaneous release of the A1 annular pulley is a treatment option for trigger finger.
Effective anesthesia is crucial for patient comfort during minimally invasive procedures.

Purpose of the Study:

To evaluate the safety and efficacy of transdermal eutectic mixture of lidocaine and prilocaine (EMLA) for percutaneous trigger finger release.
To compare EMLA transdermal anesthesia with traditional lidocaine infiltration anesthesia.
To assess patient pain perception and satisfaction with both anesthetic methods.

Main Methods:

A prospective, randomized study involving 50 patients with trigger finger syndrome.
Group A (n=25) received transdermal EMLA applied 120 minutes pre-operatively.
Group B (n=25) received local lidocaine infiltration anesthesia.
Pain was measured using the Visual Analogue Pain Scale (VAPS); effectiveness was rated on a 5-point scale.

Main Results:

No significant difference in VAPS scores during the operation between EMLA and lidocaine groups (1.33 vs 1.59).
Patient satisfaction scores were comparable between groups (4.6 vs 4.4).
VAPS scores during anesthesia administration were significantly lower in the EMLA group (0 vs 5.96).

Conclusions:

Transdermal EMLA provides effective anesthesia for percutaneous trigger finger release, significantly reducing pain during administration.
EMLA is a safe and efficient alternative to local infiltration anesthesia, suitable for office-based procedures.
Patients reported high satisfaction with the final surgical outcome using EMLA.