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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

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Related Experiment Video

Updated: Jan 13, 2026

Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors

Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors

Published on: September 27, 2019

Comparative Pain Assessment of Intradermal Versus Subdermal Skin Booster Injections Using PDLLA: A Randomized,

Kyuho Yi¹, Isabella Rosellini², Kian Hong Lau³

¹Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea. kyuho90@daum.net.

Aesthetic Plastic Surgery

|January 7, 2026

Summary

This summary is machine-generated.

Subdermal Poly-D,L-lactic acid (PDLLA) injections are significantly less painful than intradermal injections for skin rejuvenation. This finding suggests subdermal administration may enhance patient comfort and compliance.

Keywords:

Cosmetic techniques Injections, intradermal Injections, subcutaneous Pain measurement Polylactic acid

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Last Updated: Jan 13, 2026

Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors

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Published on: September 27, 2019

Determining heat and mechanical pain threshold in inflamed skin of human subjects

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Published on: January 14, 2009

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Area of Science:

Dermatology
Aesthetic Medicine
Biomaterials Science

Background:

Poly-D,L-lactic acid (PDLLA) skin boosters are utilized for biostimulatory skin rejuvenation.
Limited comparative data exists on pain perception between different injection techniques for PDLLA.

Purpose of the Study:

To compare patient-reported pain between intradermal and subdermal PDLLA injections.
Utilized a randomized, double-blinded, split-injection design for robust comparison.

Main Methods:

Twenty-one participants received ten facial injections (five intradermal, five subdermal) using a 32G needle.
Pain was quantified using the Visual Analogue Scale (VAS) immediately post-injection.
Primary outcome: difference in mean VAS scores; secondary: age and gender effects.

Main Results:

Intradermal injections yielded significantly higher mean VAS scores (6.18) compared to subdermal injections (3.85).
No significant gender-based pain differences were observed.
Younger patients (<40) reported increased pain with intradermal injections, but age did not affect subdermal pain.

Conclusions:

Subdermal PDLLA injections are substantially less painful than intradermal injections.
Lower nerve density and dermal resistance likely contribute to reduced pain with subdermal administration.
Subdermal injection is a potentially preferable method for improved patient comfort and compliance.