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Pilot study Lidocaine vs Bupivacaine

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Julian Diaz Abele

on 19 June 2014

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Transcript of Pilot study Lidocaine vs Bupivacaine

By S. Aldekhayel, J. Lee, J. Diaz Abele, M. Luc

Lidocaine with epinephrine vs. Bupivacaine with epinephrine as local anesthetic agents in wide-awake hand surgery: an outcome study of patient’s pain perception


Acknowledgments

Vs. Lidocaine
(Short acting)

Better post-op pain control

Less post-op analgesics

α

Bupivacaine
(long acting anesthetic)



Hypothesis:

Randomized controlled study comparing the two anesthetics.
For future RCT
Determine sample size needed and
Validate instruments and process
Purpose

Wide awake hand surgery
Faster and safer than GA or sedation (1)

Lidocaine and bupivacaine are the most common local anesthetics in hand surgery (2, 3)
But no studies comparing these regarding
Post-op pain
Post-op analgesic consumption
Surgical experience satisfaction

Background

Site: SMH
Single surgeon: Dr Mario Luc
Procedure: Carpal tunnel release surgery
Site of Pt recruitment: SMH and MGH
Expected duration of recruitment: 1-1.5yr
Sample size: 60 pts (30 exp., 30 control)
Dr Luc operates ~120 carpal tunnels/yr

Methods

Methods

Inclusion criteria:
>18yo
Carpal tunnel surgery under local anesthesia

Study Population

Exclusion criteria:
Chronic pain Pts.
Surgical sedation
Combined surgery
Cognitive impairment
Allergy to medications
Patients with end stage kidney or liver disease or pregnant women

Questionnaires

1. Recruit 70 Patients (expect 10 withdrawal)

2. In 1st Medical apointment Dr Luc proposes study

3. RA contacts pts interested to explain details and get consent

4. Morning of surgery RA explains to Pt questionnaires

5. RA does intraoperative log

6. Pt does post-op satisfaction questionnaire

7. Pt fills pain levels, and medication log over following 48 hrs

8. All papers collected at f/u visit
Thank you
Outcomes
Surgical satisfaction
Post-op pain
0-24hr
24-48hr
Post-op analgesia
0-24hr
24-48hr
Full transcript