Tips for a better local anaesthetic

The expert use of local anaesthetics is simple and will greatly enhance patients' acceptance of office-based procedures. Correct equipment and techniques will enable all dermatologists to practise local anaesthesia as effectively and painlessly as possible. Suggested equipment varies according to the situation, but in general Luer-Lock syringes of the smallest volume and needles of the narrowest gauge and shortest length appropriate for the procedure are recommended. Making the anaesthetic agent less acidic will minimize the pain. Techniques to minimize pain involve careful explanation to the patient, slow injection of the anaesthetic and making use of the special anatomy of the region to be anaesthetized. The number of needle pricks should be kept to a minimum. Timing of the surgical procedure should take into account the delay in onset of anaesthesia for subcutaneously injected solution and the time for injected adrenaline to produce full vasoconstriction. Planned surgical incision lines drawn out precisely prior to the injection will avoid the problem of distortion caused by tissue expansion. Gloves and appropriate eye protection should be standard and needles and syringes must be disposed of correctly.