Minimizing injection pain in local anesthesia - 11/01/13

Doi : 10.1503/cmaj.111780

Robert Strazar, BSc ^a, Don Lalonde, MD ^b,^⁎

^a Michael G. Degroote School of Medicine, McMaster University, Hamilton, Ont.

^b Division of Plastic and Reconstructive Surgery, Dalhousie University, Saint John, NB

^* Correspondence to: Don Lalonde

Plan

A smaller diameter of needle and warming the injection solution can reduce pain

Buffering lidocaine with sodium bicarbonate can minimize the typical burning sensation

The initial poke should be perpendicular to the skin, not angled

A pause allows the anesthetic to alleviate the initial pain of the injection^{^{These recommendations are based on feedback we have received from thousands of patients concerning pain on injection.}}

Keep some visible anesthetic ahead of the needle’s tip^{^{These recommendations are based on feedback we have received from thousands of patients concerning pain on injection.}}

Competing interests: Don Lalonde is a consultant for ASSI Instruments. No other competing interests were declared.
This article has been peer reviewed.