Braschi F, Bartoli F, Bruni C, Fiori G, Fantauzzo C, Paganelli L, De Paulis A, Rasero L, Matucci-Cerinic M, et al.
Clinical rheumatology. Date of publication 2017 Jan 1;volume 36(1):209-212.
1. Clin Rheumatol. 2017 Jan;36(1):209-212. doi: 10.1007/s10067-016-3414-7. Epub 2016
Sep 29.
Lidocaine controls pain and allows safe wound bed preparation and debridement of
digital ulcers in systemic sclerosis: a retrospective study.
Braschi F(1)(2), Bartoli F(3)(4), Bruni C(1)(2), Fiori G(1)(2), Fantauzzo
C(1)(2), Paganelli L(1)(2), De Paulis A(5), Rasero L(6), Matucci-Cerinic M(1)(2).
Author information:
(1)Department of Experimental and Clinical Medicine, University of Florence,
Florence, Italy.
(2)Department of Geriatric Medicine Division of Rheumatology AOUC, University of
Florence, Florence, Italy.
(3)Department of Experimental and Clinical Medicine, University of Florence,
Florence, Italy. francesca.bartoli19@gmail.com.
(4)Department of Geriatric Medicine Division of Rheumatology AOUC, University of
Florence, Florence, Italy. francesca.bartoli19@gmail.com.
(5)Department of Translational Medical Sciences and Center for Basic and Clinical
Immunology Research (CISI), University of Naples Federico II, Naples, Italy.
(6)Department of Public Health AOUC, University of Florence, Florence, Italy.
In Systemic Sclerosis (SSc), digital ulcers (DU) are painful, difficult to heal,
and frequently infected. To reduce the risk of bacterial infection and to prevent
chronicity, it is essential to carefully remove necrotic tissue from DU, with
maximum patient comfort. Debridement, although very efficacious, is invasive and
causes local pain: lidocaine is a local anesthetic commonly used as to fight pain
during debridement procedures. The aim of the study was to evaluate the efficacy
of lidocaine 4 % in pain control during debridement procedure of DU in SSc. One
hundred eight DU characterized by pain Numeric Rating Scale (NRS) >3/10 before
starting the procedure were treated with lidocaine 4 % (lidocaine cloridrate
200 mg in 5 ml of injecting solution). Pain was measured with NRS (0-10) before
starting debridement, after 15 min of lidocaine application and at the end of the
procedure. In DU, in respect to baseline (mean NRS 6.74 ± 2.96), pain after
application of lidocaine 4 % for 15 min was significantly lower (mean NRS
2.83 ± 2.73) (p < 0.001). At the end of the procedure, pain control was still
maintained and significantly lower (mean NRS 2.88 ± 2.65) in respect to baseline
(p < 0.001). No systemic adverse event due to topical lidocaine were observed. In
SSc, topical application of lidocaine 4 % significantly reduces pain, allowing a
safe debridement procedure, thus improving the management of DU.
DOI: 10.1007/s10067-016-3414-7
PMID: 27686661 [Indexed for MEDLINE]
