[Experience of articaine use in surgical treatment of patients with whitlow].

Abstract

The issue of the treatment of purulent-inflammatory conditions affecting the fingers is a significant one, given the high prevalence of such cases, with up to 1.5 million instances reported annually in our country. The results of surgical treatment are frequently unsatisfactory, particularly in regard to functional indices, even in cases of mild soft tissue injury. The primary determinant of successful whitlow treatment is adequate anaesthesia, which enables the performance of high-quality surgical wound treatment.

Objective: To conduct a comparative analysis of the efficacy of local anaesthetics (2% Novocain, 2% Lidocain and 2% solution of Artikain-Binergy) in conducting anaesthesia in accordance with the Oberst-Lukashevich technique for surgical treatment of patients with whitlow.

Material and methods: The retrospective observational study included 124 patients, of whom 83 (67%) were male and 41 (33%) were female, with an age range of 27 to 64 years. The patients were divided into three groups: the first group received 2% Novocaine (n=42), the second group received 2% Lidocaine solution (n=41), and the third group received 2% Articaine solution (n=41). The rapidity of onset of the analgesic effect (duration of latent period), its duration, and the absence of the need for repeated application of the drug were evaluated.

Results: For local anesthesia with articaine and lidocaine the same amount of drug was required - 2-3 ml, which is less than when using novocaine - 3-4 ml (p<0.05); articaine has the shortest latent period of 5-7 minutes, in contrast to lidocaine - 6-9 minutes and novocaine - 8-10 minutes (p<0.05); the duration of the analgesic effect of articaine is longer than that of lidocaine, novocaine - 3-3.5 hours, 0.83-1.33 hours and 0.58-0.66 hours, respectively (p<0.05); in the articaine group repeated anesthesia was not required either after 1 hour or after 2 hours.

Conclusion: Articaine demonstrated the greatest efficacy as a local anaesthetic in the surgical treatment of whitlow. It has the shortest latency period, which facilitates manipulation. The prolonged analgesic effect with a reduced anaesthetic dose allows for surgical procedures to be conducted without the necessity for post-procedure analgesics.