Minimizing the pain in local anesthesia injection – A review

Authors

  • Sajad Ahmad Salati Department of Surgery, Unaizah College of Medicine, Qassim University, KSA

DOI:

https://doi.org/10.66344/jpad.v26i2.56

Keywords:

Local injection, pain, buffer, pH, lignocaine, needle, distraction, spray

Abstract

Local anesthesia is widely used in dermatological surgery. But a major concern with their use is the pain experienced by the patients at the time of injection. Various tips and tricks have been published in various studies to minimize this pain .The present review article is written to revisit those tips in the light of the recent literature.

References

1. Park KK. Minimize that “Pinch and Burn”: Tips and tricks to reduce injection pain with local anesthetics. Am J Orthop. 2015; 95:E28-E29.

2. Krathen RA, Donnelly HB. Warmed local anesthetic for dermatologic surgery. Dermatol Surg. 2008;34:1239-40.

3. Sultan J. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. The effect of warming local anaesthetics on pain of infiltration. Emerg Med J. 2007;24:791-3.

4. Hogan ME, vander Vaart S, Perampaladas K, Machado M, Einarson TR, Taddio A. Systematic review and meta-analysis of the effect of warming local anesthetics on injection pain. Ann Emerg Med. 2011;58:86-98.e1.

5. Allen MJ, Bunce C, Presland AH. The effect of warming local anaesthetic on the pain of injection during sub-Tenon's anaesthesia for cataract surgery. Anaesthesia. 2008;63:276-8.

6. Bell RW, Butt ZA. Warming lignocaine reduces the pain of injection during peribulbar local anaesthesia for cataract surgery. Br J Ophthalmol. 1995;79:1015-7.

7. Frank SG, Lalonde DH. How acidic is the lidocaine we are injecting, and how much bicarbonate should we add? Can J Plast Surg. 2012;20:71-3.

8. Zilinsky I, Bar-Meir E, Zaslansky R, Mendes D, Winkler E, Orenstein A. Ten commandments for minimal pain during administration of local anesthetics. J Drugs Dermatol. 2005;4:212-6.

9. Momsen OH, Roman CM, Mohammed BA, Andersen G. Neutralization of lidocaine-adrenaline. A simple method for less painful application of local anesthesia. Ugeskr Laeger. 2000;162:4391-4.

10. Bronfenbrener R. Giving a good needle: Resident guide to decreasing injection pain. Cutis. 2014;93:E13-E15

11. Thompson KD, Welykyj S, Massa MC. Antibacterial activity of lidocaine in combination with a bicarbonate buffer. J Dermatol Surg Oncol. 1993;55:216-20.

12. Ong EL, Lim NL, Koay CK. Towards a pain-free venipuncture. Anaesthesia. 2000;55:260-2.

13. Mustoe TA, Buck DW II, Lalonde DH. The safe management of anesthesia, sedation, and pain in plastic surgery. Plast Reconstr Surg. 2010;126:e165-e176.

14. Strazar R, Leynes PG, Lalonde DH. Minimizing the pain of local anesthesia injection. Plast Reconstr Surg. 2013;132:675-84.

15. Farhangkhoee H, Lalonde J, Lalonde DH. Teaching medical students and residents how to inject local anesthesia almost painlessly. Can J Plast Surg. 2012;20:169-72.

16. Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012;27:652-81.

17. Singer AJ, Stark MJ. LET versus EMLA for pre-treating lacerations: a randomized trial. Acad Emerg Med. 2001;8:223-30.

18. Adler AJ, Dubinisky I, Eisen J. Does the use of topical lidocaine, epinephrine, and tetracaine solution provide sufficient anesthesia for laceration repair? Acad Emerg Med. 1998;5:108-12.

19. Dixit S, Lowe P, Fischer G, Lim A. Ice anaesthesia in procedural dermatology. Australas J Dermatol. 2013;54:273-6.

20. Skarbek-Borowska S, Becker BM, Lovgren K, Bates A, Minugh PA. Brief focal ultrasound with topical anesthetic decreases the pain of intravenous placement in children. Pediatr Emerg Care. 2006;22:339-45.

21. Logomasini MA, Stout RR, Marcinkoski R. Jet injection devices for the needle-free administration of compounds, vaccines, and other agents. Int J Pharm Compd. 2013;17:270-80.

22. Cooper JA, Bromley LM, Baranowski AP, Barker SG. Evaluation of a needle-free injection system for local anaesthesia prior to venous cannulation. Anaesthesia. 2000;55:247-50.

23. Zempsky WT, Robbins B, Richards PT, Leong MS, Schechter NL. A novel needle-free powder lidocaine delivery system for rapid local analgesia. J Pediatr. 2008;152:405-11.

Downloads

Published

17.11.2016

Issue

Section

Review Articles

How to Cite

1.
Minimizing the pain in local anesthesia injection – A review. J Pak Assoc Dermatol [Internet]. 2016 Nov. 17 [cited 2026 Jul. 26];26(2):138-42. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/56