REDUCTION OF TRAUMATIC SECONDARY SHOULDER DISLOCATIONS WITH LIDOCAINE

The aim of the present study was to evaluate the value of local anaest hesia versus the commonly used intravenous pethidine/diazepam in the r eduction of acute secondary shoulder dislocations. Patients with a tra umatic secondary dislocation of the shoulder were randomized to either locally injected lidocaine or intravenously injected pethidine/diazep am. The local method was performed with 20 ml of 1% lidocaine. The pat ients were observed for any complication during and after the procedur e, and the methods used were evaluated with a visual analogue scale (V AS). From November 1991 to September 1993, 62 patients were admitted t o our departments of whom 52 were included in the study. Average age w as 47 years (range 18-89 years) with 24 men and 28 women. Twenty-six p atients were randomized to pethidine/diazepam; 22 had a successful red uction, and 4 were failures. Twenty-six patients received lidocaine, o f whom 18 were successful and 8 not. Three patients treated with the-i ntravenous 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 th e lidocaine group. There was no statistical difference between the ave rage VAS value in the two groups. Lidocaine used to reduce acute secon dary dislocations of the shoulder is a simple and safe method. It is a s effective as the standard intravenous method and is well accepted by patients.