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Trigger Finger Corticosteroid Injection With and Without Local Anesthetic: A Randomized, Double-Blind Controlled
J Randall Patrinely1, Shepard P Johnson2, Brian C Drolet2
1Vanderbilt University School of Medicine, Nashville, TN, USA.
Hand (New York, N.Y.)
|November 7, 2019
Summary
Corticosteroid injections effectively treat trigger finger. However, adding local anesthetic like lidocaine with epinephrine increases injection pain. Excluding anesthetic reduces pain, simplifying the procedure.
Area of Science:
- Orthopedics
- Musculoskeletal Disorders
- Pain Management
Background:
- Trigger finger is commonly treated with corticosteroid injections.
- Injectable solutions often include local anesthetics, but their impact on injection pain is debated.
Purpose of the Study:
- To investigate whether local anesthetic (lidocaine with epinephrine) increases pain during corticosteroid injections for trigger finger.
Main Methods:
- Prospective randomized study comparing triamcinolone with lidocaine/epinephrine versus triamcinolone with saline placebo.
- Patients and surgeons were blinded to the treatment allocation.
- Pain was assessed immediately post-injection using a Visual Analog Scale (VAS).
Main Results:
- Seventy-three patients (110 trigger fingers) were analyzed.
- Injections with lidocaine/epinephrine resulted in significantly higher pain scores (VAS 3.5) compared to placebo (VAS 2.0).
Conclusions:
- Corticosteroid injections are effective for trigger finger with generally low pain.
- Including lidocaine with epinephrine in corticosteroid injections increases immediate post-injection pain.
- Excluding anesthetic may be preferable for reduced pain, simplicity, and safety, though patient counseling regarding short-term anesthesia is advised.
