Intra-articular lidocaine reduces pain in anterior shoulder dislocations: Study

The successful reduction of anterior shoulder dislocations in the emergency department (ED) may be achieved using intra-articular lidocaine in a manner comparable to that of intravenous sedation, says an article published in Canadian Journal of Emergency Medicine.

In the emergency room, anterior shoulder dislocations are often treated. Intra-articular lidocaine (IAL) injection or intravenous sedation are two methods of providing analgesia for reduction (IV sedation). This study was done by Arjun Sithamparapillai and his colleagues to compare closed reduction of acute anterior shoulder dislocation under IAL and IV sedation in the emergency department.

Reference lists were manually searched, and electronic searches of MEDLINE and EMBASE (1946–September 2021) were performed. IAL and IV sedation were compared in randomized controlled trials (RCTs) to reduce acute anterior shoulder dislocations in ED patients under the age of 15. A successful reduction, adverse events, duration of stay in the emergency department, pain ratings, ease of reduction, procedure time, patient satisfaction, and cost were among the outcomes of interest. Two reviewers independently selected abstracts, judged the caliber of the studies, and collected data. Mean differences and risk ratios (RR) with 95% confidence intervals were produced as a result of pooling the data using random-effects models.