The aim of the present study was to evaluate the value of local anaesthesia versus the commonly used intravenous pethidine/diazepam in the reduction of acute secondary shoulder dislocations. Patients with a traumatic secondary dislocation of the shoulder were randomized to either locally injected lidocaine or intravenously injected pethidine/diazepam. The local method was performed with 20 ml of 1 % lidocaine. The patients were observed for any complication during and after the procedure, and the methods used were evaluated with a visual analogue scale (VAS). From November 1991 to September 1993, 62 patients were admitted to our departments of whom 52 were included in the study. Average age was 47 years (range 18–89 years) with 24 men and 28 women. Twenty-six patients were randomized to pethidine/diazepam; 22 had a successful reduction, and 4 were failures. Twenty-six patients received lidocaine, of whom 18 were successful and 8 not. Three patients treated with the intravenous method suffered respiratory depression, and one required an antidote. No systemic or local side-effects, no neurovascular damage and no early or late superficial or deep infection were recorded in the lidocaine group. There was no statistical difference between the average VAS value in the two groups. Lidocaine used to reduce acute secondary dislocations of the shoulder is a simple and safe method. It is as effective as the standard intravenous method and is well accepted by patients.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Anderson D, Zvirbulis R, Ciullo J (1991) Scapular manipulation for reduction of anterior shoulder dislocations. Clin Orthop, pp 181–182
Baker CL, Uribe JW, Courtenay W (1990) Arthroscopic evaluation of acute initial anterior shoulder dislocations. Am J Sports Med 18:25–28
Bewley TH (1972) Opioid analgesics and narcotic antagonists. In: Mayler L, Herxheimer A (eds). Side effects of drugs. Excerpta Medica, Amsterdam, pp 126–128
Christiansen TG, Nielsen R (1988) Reduction of shoulder dislocations under interscalene brachial blockade. Arch Orthop Trauma Surg 107:176–177
Cortes VC, Garcia-Dihinx L, Vela JR (1989) Reduction of acute anterior dislocations of the shoulder without anaesthesia in the position of maximum muscular relaxation. Int Orthop 13:259–262
Dahl MR, Dasta JF, Zueler W, McSweeney TD (1990) Lidocaine local anesthesia for arthroscopic knee surgery. Anesth Analg 71:670–674
Goodman E (1985) Opioid analgesics and antagonists. In: Goodman and Gilman's the pharmacological basis of therapeutics. Macmillan, New York 6:494–534
Harle A, Tscherne H, Weissauer WZ (1988) Treatment protocol in suspicion and diagnosis of a joint infection following intraarticular injections and punctures. Unfallchir Versicherungsmed Berufskr 81:11–16
Johnson G, Hulse W, McGowan A (1992) The Milch technique for reduction of anterior shoulder dislocations in an accident and emergency department. Arch Emerg Med 9:40–43
Joshi GP, McCaroll SM, O'Brien TM, Lenane P (1993) Intraarticular analgesia following knee surgery. Anesth Analg 76:333–336
Lippit S (1991) Treatment of shoulder dislocations with lidocaine. Anesthesiol Topics 10:6
Massey T, Huang TL, Malinick R, Zell M (1988) Serum lidocaine levels during arthroscopy using continuous irrigation with lidocaine. Clin Orthop 229:182–184
Riebel GD, McCabe JB (1991) Anterior shoulder dislocation. A review of reduction techniwues. Am J Emerg Med 9:180–188
Rowe C (1980) Acute and recurrent anterior dislocation of the shoulder. Orthop Clin North Am 11:253–270
Royle G (1973) Treatment of acute anterior dislocation of the shoulder. Br J Clin Pract 27:403–404
Sperber A, Wredmark T (1993) Shoulder arthroscopy with the use of local anaesthesia. J Shoulder Elbow Surg 2:106–109
Underhill TJ, Wan A, Morrice M (1989) Interscalene brachial plexus block in the management of shoulder dislocation. Arch Emerg Surg Med 6:199–204
Waldron VD, Hazel D (1991) Technique for reduction of shoulder dislocation. Orthop Rev 20:563–566
About this article
Cite this article
Suder, P.A., Mikkelsen, J.B., Hougaard, K. et al. Reduction of traumatic secondary shoulder dislocations with lidocaine. Arch Orthop Trauma Surg 114, 233–236 (1995). https://doi.org/10.1007/BF00444270
- Public Health
- Statistical Difference
- Visual Analogue Scale