Fig. 15.1
Experienced pain during injection and interval. Mean visual analog scale (VAS) scores for pain experienced during the first injection (buffered mepivacaine in the local anesthesia [LA] group; collagenase in the no-LA group) and during the time period (1 or 2 days) from the injection to the finger extension procedure
15.4 Summary
In patients with Dupuytren contracture treated with collagenase injection, administering local anesthesia before the collagenase injection significantly reduces the patients’ pain experience at the time of injection. It does not however reduce the pain experienced during the time interval up to the finger extension procedure because the effect of mepivacaine has a relatively short duration that is not prolonged by the sodium bicarbonate.
References
Atroshi I, Strandberg E, Lauritzson A, Ahlgren E, Walden M (2014) Costs for collagenase injections compared with fasciectomy in the treatment of Dupuytren’s contracture: a retrospective cohort study. BMJ Open 4(1):e004166CrossRefPubMedPubMedCentral