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Randomized, Double Blinded Comparative Trial of Intradermal Injections of Lignocaine Versus N-Saline Around the Knee to Relieve Pain in Patients Awaiting Total Knee Replacement

Loughnan, Terence Edward MBBS, FANZCA*; Taverner, Murray G. MBBS, FANZCA, FRCA, FFPMANZCA, FIPP; Webb, Ashley MBBS, FANZCA*

The Clinical Journal of Pain: May 2009 - Volume 25 - Issue 4 - p 269-272
doi: 10.1097/AJP.0b013e3181929877
Original Articles

Objectives We report a randomized, double-blinded comparative study assessing the efficacy of local anesthetic with N-saline intradermal blocks around the knee to reduce pain and improve patient satisfaction while waiting for a total knee joint replacement.

Methods Patients were offered involvement in this study while on the hospital waiting list for a knee replacement. Eligible patients, after completing a prestudy assessment, received an average of 6.3 (range: 1 to 10) intradermal injections of 0.5 mL either saline or 1% lignocaine injections into tender points around the knee. Patients were assessed at 2 hours and 1 week after the injections. Pain was assessed using 0 to 100 visual analog pain scale. Global perceived effect (satisfaction) was measured on a 7-point Likert scale.

Results Thirty-two of 34 patients attended at 1-week assessment, 24 (75%) felt that they were improved, and 8 (25%) considered they were unchanged or worse. In both the saline and lignocaine groups, 12 of 16 patients felt that they had improved. N-saline proved as effective as lignocaine in reducing knee pain when injected intradermally. Seventy-five percent of patients were improved at 1 week.

*Department of Anaesthesia and Pain Management

Peninsula Health, Frankston, Victoria, Australia

Reprints: Terence Edward Loughnan, MBBS, FANZCA, Director of Education and Research, Department of Anaesthesia and Pain Management, Peninsula Health, Frankston Hospital, Hastings Road, Frankston 3199, Victoria, Australia (e-mail:

Received for publication August 6, 2008; revised September 23, 2008; accepted September 27, 2008

Sources of support: The authors received a $5000 grant from the Peninsula Health Research Development Fund.

© 2009 Lippincott Williams & Wilkins, Inc.