Skin Cooling to Reduce the Pain Associated with Local Anesthetic Injection; a Randomized Controlled Trial
Archives of Academic Emergency Medicine,
Vol. 10 No. 1 (2022),
1 Dey 2022
,
Page e20
https://doi.org/10.22037/aaem.v10i1.1562
Abstract
Introduction: Different methods have been proposed for the reduction of the pain caused by the injection of local anesthetics. This study aimed to evaluate the effect of skin cooling on reduction of pain associated with local injection of lidocaine buffered with sodium bicarbonate.
Methods: This randomized controlled trial included 108 adult patients with arm/forearm wounds who referred to the emergency departments. Participants were randomly allocated to two equal groups. Patients in both groups received subcutaneous injection of buffered lidocaine. In the intervention group, an ice cube measuring 2 × 2 × 2 cm (at 0 ° C) in sterile gloves were placed on the wound for 2 minutes before the injection of buffered lidocaine. The primary outcome was severity of pain during lidocaine injection using a visual analog scale (VAS).
Results: One hundred and eight patients were enrolled in the study, 54 in each group. There was no statistically significant difference in age (p = 0.777), sex (p = 0.466), and length of laceration (p = 0.410) between the two groups. The pain scores during lidocaine injection were significantly lower in the intervention group compared to control group (2.39 ± 1.14 vs 4.26 ± 0.94, p < 0.001).
Conclusions: Skin cooling prior to the injection of local anesthetics can significantly reduce the pain caused by local anesthetic infiltration
- Lidocaine
- Wounds and Injuries
- Injections
- Anesthesia, Local
- Pain
- Emergency Service
- Hospital
How to Cite
References
Eshkevari L, Trout KK, Damore J. Management of postpartum pain. J Midwifery Womens Health. 2013;58(6):622-31.
Song J, Kim H, Park E, Ahn JH, Yoon E, Lampotang S, et al. Pre-emptive ice cube cryotherapy for reducing pain from local anaesthetic injections for simple lacerations: a randomised controlled trial. Emerg Med J. 2018;35(2):103-7.
Finsen V. Reduced pain when injecting lidocaine. Tidsskr Nor Laegeforen. 2017;137(9):629-30.
Azizkhani R, Sani MS. Topical Lidocaine plus Diclofenac as a Local Anesthetic Agent in Central Venous Catheterization; a Randomized Controlled Clinical Trial. Arch Acad Emerg Med. 2021;9(1):e63.
Mahshidfar B, Shevi SC, Abbasi M, Kasnavieh MH, Rezai M, Zavereh M, et al. Ice Reduces Needle-Stick Pain Associated With Local Anesthetic Injection. Anesth Pain Med. 2016;6(5):e38293.
Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician. 2003;6(3):345-60.
Hijazi R, Taylor D, Richardson J. Effect of topical alkane vapocoolant spray on pain with intravenous cannulation in patients in emergency departments: randomised double blind placebo controlled trial. BMJ. 2009;338.
Bastami M, Azadi A, Mayel M. The Use of Ice Pack for Pain Associated with Arterial Punctures. J Clin Diagn Res. 2015;9(8):JC07-9.
Goel S, Chang B, Bhan K, El-Hindy N, Kolli S. “Cryoanalgesic preparation” before local anaesthetic injection for lid surgery. Orbit. 2006;25(2):107-10.
Watkins AA, Johnson TV, Shrewsberry AB, Nourparvar P, Madni T, Watkins CJ, et al. Ice packs reduce postoperative midline incision pain and narcotic use: a randomized controlled trial. J Am Coll Surg. 2014;219(3):511-7.
Gostimir M, Hussain A. A systematic review and meta-analysis of methods for reducing local anesthetic injection pain among patients undergoing periocular surgery. Ophthalmic Plast Reconstr Surg. 2019;35(2):113-25.
Bhadauria US, Sandesh N, MISHRA P, GODHA S. Effect of injection site pre-cooling on pain perception in patients attending a dental camp at life line express: a split mouth interventional study. Clujul Med. 2017;90(2):220.
Patel BK, Wendlandt BN, Wolfe KS, Patel SB, Doman ER, Pohlman AS, et al. Comparison of two lidocaine administration techniques on perceived pain from bedside procedures: a randomized clinical trial. Chest. 2018;154(4):773-80.
Strazar AR, Leynes PG, Lalonde DH. Minimizing the pain of local anesthesia injection. Plast Reconstr Surg. 2013;132(3):675-84.
Bose S, Garg N, Pathivada L, Yeluri R. Cooling the soft tissue and its effect on perception of pain during infiltration and block anesthesia in children undergoing dental procedures: a comparative study. J Dent Res Dent Clin Dent Prospects. 2019;13(3):159.
Yoon WY, Chung SP, Lee HS, Park YS. Analgesic pretreatment for antibiotic skin test: vapocoolant spray vs ice cube. Am J Emerg Med. 2008;26(1):59-61.
Nadler SF, Weingand K, Kruse RJ. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician. 2004;7(3):395-400.
Muldoon J. Skin cooling, pain and chronic wound healing progression. Br J Community Nurs. 2006;11(Sup1):S21-S5.
East CE, Dorward ED, Whale RE, Liu J. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database Syst Rev. 2020;10(10):CD006304.
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