Appréciation de la place de l’anesthésie locorégionale pour la prise en charge des plaies de la face aux urgences

Abstract

ObjectiveDefining the place of regional anaesthesia (RA) for facial wounds in an emergency department. Study DesignProspective observational study conducted in the emergency department of a regional hospital. Patients and methodsTwo hundred and forty-six successive patients with one or more facial wounds were included from 1st august 2004 to 31st december 2004. Data on patient, operator, wound (measured by the number of stitches), anaesthetic method (RA, local anaesthesia [LA], or no anaesthesia), method of repairing skin, duration of intervention, operator comfort (verbal numeric scale [VNS] from 0 to 10) and pain feeled by the patient (visual analogic scale [VAS] from 0 to 10) in the different stages of care were collected. ResultsCompared to the LA, the RA of the face decreased the number of punctures (1.36 vs 4.38 punctures, p<0.001) and the quantity of local anaesthetic injected (2.8ml vs 5.3ml, p<0.01) for wounds requiring more than 10 stitches. It has improved operator comfort (VNS=10 [8–10] vs 8 [6.75–10] (p<0.01)). Its effectiveness during skin repair was equivalent to that of the LA by infiltration (VAS 0 [0–1] vs 0 [0–1]). ConclusionWhen practicable, the RA of the face is a better technique than the LA for facial wounds treatment.