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Pain reduction in lidocaine administration through buffering and warming
K B Colaric1, D T Overton, K Moore
1Department of Emergency Medicine Methodist Hospital, Omaha, NB, USA.
The American Journal of Emergency Medicine
|July 22, 1998
Summary
Warming and buffering lidocaine significantly reduces injection pain. Warmed, buffered lidocaine offers the greatest pain relief compared to plain or warmed lidocaine alone.
Area of Science:
- Anesthesiology
- Pain Management
- Pharmacology
Background:
- Intradermal lidocaine injections can cause significant pain.
- Strategies to mitigate injection pain are clinically relevant.
Purpose of the Study:
- To compare the pain associated with intradermal infiltration of plain lidocaine, warmed lidocaine, buffered lidocaine, and warmed, buffered lidocaine.
Main Methods:
- A randomized, double-blind, Latin Square design was employed with 20 volunteers.
- Each volunteer received 16 injections under controlled conditions, serving as their own control.
- Pain was assessed using mean pain scores for each of the four tested lidocaine solutions.
Main Results:
- Warmed, buffered lidocaine yielded the lowest mean pain score (29.2), significantly less than all other solutions.
- Buffered lidocaine (36.7) was less painful than plain lidocaine (44.2) and warmed lidocaine (42.2).
- Warmed lidocaine did not show a significant difference in pain scores compared to plain lidocaine.
Conclusions:
- Warmed, buffered lidocaine significantly reduces pain during intradermal injection compared to plain, warmed, or buffered lidocaine alone.
- Buffering lidocaine decreases pain perception.
- Heating buffered lidocaine may enhance pain reduction in clinical practice.
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