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Long-Term Safety of Using Local Anesthetic Injections in Professional Rugby League for Modified Indications

Sebak, Safaa, MEng*; Orchard, John W., MD, PhD, FACSEP; Golding, Leigh D., MBChB; Steet, Elizabeth, FACP§; Brennan, Steph A., MSc; Ibrahim, Ameer, MBBS, FACSEP, FFSEM(UK)

Clinical Journal of Sport Medicine: September 2018 - Volume 28 - Issue 5 - p 435–442
doi: 10.1097/JSM.0000000000000525
Original Research

Objective: To assess and evaluate the long-term safety of local anesthetic injections before or during games in professional rugby league players.

Design: Retrospective case series.

Setting: Professional rugby league team.

Participants: Sydney Roosters players over a 6-year period (2008-2013), who had been administered a local anesthetic injection for an injury before or during a match to aid return to play.

Interventions: Follow-up survey (no active intervention).

Main Outcome Measures: Player self-reported satisfaction. Survey results were compared with a previous cohort who had received local anesthetic injection from 1998 to 2007.

Results: Thirty-two players who had been injected with local anesthetic on 249 occasions for 81 injuries completed the current survey at an average of 5.64 years postinjection. In the cohort of 2008 to 2013, fewer injections were performed to areas deemed higher risk compared with the 1998 to 2007 cohort (P < 0.00002). The vast majority of players (80/81 cases) would repeat the injection in the same circumstances and reported that ongoing side effects were uncommon. There were 6 cases (8%) in which players reported significant ongoing pain in the area of injection at long-term follow-up.

Conclusions: This study affirmed the long-term safety of injections in most cases.

Level of Evidence: IV.

*Sydney Medical School, University of Sydney, Sydney, Australia;

School of Public Health, University of Sydney, Sydney, Australia;

Sports Medicine, Sydney University, Sydney, Australia;

§South Sydney Sports Medicine, Sydney, Australia; and

Sydney Roosters, Sydney, Australia.

Corresponding Author: John W. Orchard, MD, PhD, FACSEP, Sports Medicine at Sydney University, Cnr Western Ave & Physics Rd, University of Sydney, NSW 2006, Australia (

S. A. Brennan and A. Ibrahim currently work for (and J. W. Orchard and E. Steet previously worked for) the Sydney Roosters rugby league team as part of paid medical staff. The remaining authors report no conflicts of interest.

Received March 28, 2017

Accepted July 22, 2017

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