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Safety of Lidocaine During Wide-Awake Local Anesthesia No Tourniquet for Distal Radius Plating
Shalimar Abdullah1, Muhamad Fitri Tokiran2, Amir Adham Ahmad3
1Hand and Microsurgery Unit, Department of Orthopaedics and Traumatology, Hospital Canselor Tuanku Muhriz, Universiti Kebangasaan Malaysia, Kuala Lumpur, Malaysia.
Purpose:
This study evaluated the clinical and biochemical safety profile of infiltration of lidocaine with adrenaline in wide-awake local anesthesia no tourniquet for distal radius plating.
Methods:
Twenty-four participants were randomly assigned to the therapeutic group (n = 19) (1% lidocaine in 1:100,000 adrenaline) and control group (n = 5) (2% lidocaine alone). Clinical parameters, including skin necrosis, duration of recovery of sensation, and lidocaine toxicity, were monitored. The serum lidocaine level was measured at different time intervals using a high-performance liquid chromatography reagent.
Results:
No lidocaine toxicity was recorded in any participant. The therapeutic group had a longer time for recovery of sensation. There was a significant difference in the serum lidocaine levels between both the groups at all time intervals up to 6 hours, with all participants exhibiting serum lidocaine levels below the mild toxicity level of 6.0 μg/mL.
Conclusions:
Lidocaine used within a safe recommended dose in wide-awake local anesthesia no tourniquet for distal radius plating is clinically and biochemically safe.
Clinical Relevance:
Determining the clinical and biochemical safety profile of lidocaine with adrenaline in wide-awake local anesthesia no tourniquet can promote wider use of this technique.
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