The aim of this study was to evaluate the level of pain felt when silicone ring and pneumatic tourniquets were applied to the upper arm and to determine which was more suitable for use in local anaesthetic procedures. Pain was measured using a visual analogue score pain scale on application and at 1, 5, and 10 minutes in 30 volunteers. Volunteers experienced significantly more pain on application and at 1 and 5 minutes with the silicone ring tourniquet. This difference in pain was most marked on application. Two volunteers could not tolerate application of the silicone ring tourniquet. We conclude that the silicone ring tourniquet would not be suitable for local anaesthetic procedures in the upper limb due to the severe pain experienced on application, which may reduce the patients' confidence and adversely affect their experience of the procedure. The pneumatic tourniquet is more suitable for local procedures.
AbstractObjectivesThe study aims were to assess the burden of non-traumatic wrist pain in terms of numbers of referrals to secondary care, and to characterise how patients present, are diagnosed and are managed in secondary care in the United Kingdom National Health Service.MethodsTen consecutive patients presenting with non-traumatic wrist pain were identified retrospectively at each of 16 participating hospitals and data was extracted for twelve months following the initial referral.ResultsThe 160 patients consisted of 100 females and 60 males with a median age of 49, accounting for approximately 13% of all new hand/wrist referrals. The dominant wrist was affected in 60% of cases and the mean symptom duration was 13.3 months. Diagnoses were grouped into: osteoarthritis (OA) (31%), tendinopathy (13%), ganglion (14%), ulnar sided pain (17%) and other (25%). The OA group was significantly older than other groups, while other groups contained a predominance of females.The non-surgical interventions in decreasing frequency of usage were: steroid injections (39%), physiotherapy (32%), splint (31%) and analgesics (12%). Of those who underwent surgery, all patients had previously received non-surgical treatment, however 42% had undergone only one non-surgical intervention.ConclusionNon-traumatic wrist pain represents a significant burden to secondary care both in terms of new patient referrals and in terms of investigation, follow up and treatment. Those presenting with osteoarthritis are more likely to be older and male, while those presenting with other diagnoses are more likely to be younger and female.
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