The comparison of local infiltration anesthesia and regional nerve block for suturing traumatic hand and face lacerations by patient satisfaction

Traumatic lacerations are usually repaired after local infiltration anesthesia. Peripheral nerve block technique is used less often for this purpose. There are many advantageous aspects of peripheral nevre block over local infiltration. The purpose of this study was to compare the pain of anesthesic injection and suturation, patient satisfaction and anesthetic efficacy of local infiltration and peripheral nevre block anesthesia techniques for hand and face lacerations.A prospective, non-blind, randomized study was planned. Over 18 year-old patients that are described in exclusion and inclusion criteria were admitted in the study. Lacerations were in dermatomes innervated by only one peripheral nevre (supraorbital, infraorbital, mental, ulnar, median, radial and digital nerves? dermatomes). Standard wound care methods were used. Local infiltration and nerve block methods were selected randomly for each patient?s anesthesia. 2% lidocaine hydrochloride solution was used. Injections were made with 27gauge 4cm needles.Anesthesia injection pain and suturation pain, were measured with a 100mm visual analog scale. Patient satisfaction, was measured by a scale with 5 categories. Mean time to achieve anesthesia was determined by loss of pin-prick test sensitivity . Additional anesthesia was noted.72 patients were studied who fits the inclusion criteria. Local infiltration was performed in 36 patients and nerve block was performed in 36 patients. The average age was 34.4. Seventy-three point six percent of patients were male. Demographic properties and vital findings in two groups were homogeneous. In terms of pain scores, there was no statistically significant difference in any main or subgroups. Similarly, satisfaction ratings did not differ in any of groups. In local anesthesia group one patient required additional anesthesia and 3 patients in the nerve block group required additional anesthesia. Loss of pin-prick sensitivity time was found 1,2 minutes with local infiltration and 2,2 minutes with nerve block group. This difference was statistically significant (p = 0.001).Peripheral nerve block, often requires a single injection and a small amount of anesthetic substances (large-sized lacerations ); additionally it doesn?t cause distortion of the wound edges. These are some of the advantages of peripheral nerve block over the local infiltration. Experience requirement is one of the disadvantages of peripheral nerve block. As a conclusion, peripheral nevre block is thought to be useful like local infiltration anesthesia in emergency departments.