RT Journal Article
SR Electronic
T1 Hyaluronidase (Hyalase): a useful addition in haematoma block?
JF Journal of Accident & Emergency Medicine
JO Arch Emerg Med
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 337
OP 338
DO 10.1136/emj.13.5.337
VO 13
IS 5
A1 N J London
A1 F A Osman
A1 K Ramagopal
A1 S F Journeaux
YR 1996
UL http://emj.bmj.com/content/13/5/337.abstract
AB OBJECTIVE: To investigate whether hyaluronidase (Hyalase) is a useful and justified addition to haematoma block for pain relief. METHODS: The study was a randomised double blind trial of 33 consecutive patients attending the accident and emergency department for manipulation of distal radius fracture under haematoma block. Control patients received 1% lignocaine; the treatment group received 1% lignocaine plus 1500 IU hyaluronidase. Manipulation occurred 10 minutes after instituting the block. RESULTS: 16 patients received hyaluronidase, 17 received lignocaine only. One patient with unsuccessful manipulation was excluded. There was no significant difference between the two groups for any of three methods of pain assessment (P > 0.05, Mann Whitney). CONCLUSIONS: The addition of hyaluronidase does not increase the efficacy of the haematoma block when 10 minutes are allowed to elapse before manipulation, and the increased cost of adding (and risk of allergy) is not justified by any theoretical increased speed of analgesia.