UMEM Educational Pearls

Title: Lidocaine for shoulder discloations

Category: Orthopedics

Keywords: intra-articular lidocaine, shoulder dislocation (PubMed Search)

Posted: 1/15/2012 by Brian Corwell, MD
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Approximately 48% of shoulder dislocations occur during sports and recreation.

These are usually first managed in the clinic and sideline setting.

In 6 reviewed studies, 5 used 20mL of 1% lidocaine and 1 used 4 mg/kg of 1% lidocaine.

Patients incurred significantly reduced cost compared to IV sedation

There were no infections, neurovascular damage or systemic effects of the lidocaine.

No significant differences were noted in pain control, success rate or ease of reduction between intra-articular lidocaine and systemic sedation.

The risk of chondrolysis increases with higher concentration and longer duration of exposure to local anesthetics.

There is scant research about the effects of a single exposure of cartilage to lidocaine.

Waterbrook AL & Paul S. Intra-articular lidocaine injection for shoulder reductions: A clinical review. Sports Health, Dec 2011.