A comparison of prilocaine and lidocaine for intravenous regional anaesthesia for forearm fracture reduction in children.

Abstract

In this prospective blinded randomized study, we compared prilocaine and lidocaine for intravenous regional anaesthesia for forearm fracture reduction in children. Two hundred and seventy-nine children, aged 316 years, were enrolled and randomly assigned to receive 3 mg.kg-1 of either prilocaine or lidocaine. The severity of fracture was classified according to the displacement of the radius (i.e., no radial fracture, angulated, partly displaced or completely displaced). Pain during the procedure was assessed as none, minimal, moderate or severe. There was no significant difference between agents in the proportion of patients with a successful reduction (prilocaine 94%, lidocaine 92%). Compared with less severe fractures, successful reduction was less common in the completely displaced fractures (P < 0.001) but there was no significant difference in this category between anaesthetic agents (successful reduction: prilocaine, 84%; lidocaine, 78%). Analgesia was superior in the lidocaine group with more patients having no or minimal pain (prilocaine, 78%; lidocaine, 90%, P < 0.05). Both agents are effective for forearm fracture reduction in children with a high incidence of successful reductions, particularly in the minimally or nondisplaced fractures. Lidocaine provided superior analgesia.