Long- or Short-Acting Anesthetic with Corticosteroid in Local Injections of Overuse Injuries? A Prospective, Randomized, Double-Blind Study

• Published in: International journal of sports medicine 1990-10, Vol.11 (5), p.397-400
• Main Authors: Kannus, P., Järvinen, M., Niittymäki, S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Athletic Injuries - drug therapy; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Bupivacaine - therapeutic use; Cumulative Trauma Disorders - drug therapy; Double-Blind Method; Drug Therapy, Combination; Humans; Injections, Intra-Articular; Lidocaine - therapeutic use; Male; Medical sciences; Methylprednisolone - administration & dosage; Methylprednisolone - therapeutic use; Middle Aged; Pain - prevention & control; Pharmacology. Drug treatments; Prospective Studies
• ISSN: 0172-4622; 1439-3964
• DOI: 10.1055/s-2007-1024826

Abstract A prospective, randomized, double-blind study of 56 patients presenting with an overuse sports injury was undertaken in order to compare the effect of a long-acting anesthetic (bupivacaine) with a short-acting anesthetic (lidocaine) in local corticosteroid injections. At presentation, patients were either administered a periarticular injection of 2 ml of methyl prednisolone acetate with bupivacaine (MPA-B) (40 mgs per ml + 5 mgs per ml) or 2 ml of MPA with lidocaine (MPA-L) (40 mgs per ml + 10 mgs per ml). No other treatment was given. Results indicated that pain inhibition was better in the MPA-B group during the first six hours after the injection, obviously because of the longer half-life of bupivacaine. In later evaluations no differences could be observed: in both groups pain disappeared partly or completely in two-thirds of the patients and full recovery to sports was possible in half of them. Long-acting bupivacaine is recommended as an anesthetic substance in local steroid injections of musculoskeletal overuse injuries.