[Appreciation of the role of regional anaesthesia in managing facial wounds in the emergency unit]

Abstract

Objective: Defining the place of regional anaesthesia (RA) for facial wounds in an emergency department.

Study design: Prospective observational study conducted in the emergency department of a regional hospital.

Patients and methods: Two 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 felt by the patient (visual analogic scale [VAS] from 0 to 10) in the different stages of care were collected.

Results: Compared 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 (2.8 ml vs 5.3 ml, 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]).

Conclusion: When practicable, the RA of the face is a better technique than the LA for facial wounds treatment.