Minimizing injection pain in local anesthesia

An Open-Label Comparison of Local Anesthesia with or without Sedation for Minor Hand Surgery

“…There is some evidence that using a 27-gauge needle, buffered and warmed local anesthesia with epinephrine, no tourniquet, injecting perpendicularly to the skin and subdermally while distracting the patients (talking, pinching), with a slow rate of injection and adequate time to let the local take effect, might have different results [7,8,28].…”

“…Research to date has demonstrated some benefits of specific technical aspects of local anesthesia, but that is an area that might benefit from additional investigation [13,18,20,28]. We would also consider studies of decision aids to help patients prepare for minor surgery choose a type of anesthesia, screening measures to identify patients likely to be unhappy with local anesthesia alone, and the value of preoperative training and preparation in reducing the unpleasantness of local anesthesia [4,27].…”

Mindre smerte ved lokalbedøvelse

“…If this is used, there is probably even more reason to buffer the solution. The effect of the adrenaline in the solution will, however, be reduced by 25 % per week (4).…”

“…It has been suggested that reduced injection speed reduces the distension of the tissues because the injected fluid has more time to diffuse into the surrounding tissue, and that the free nerve endings have time to adapt to the increased pressure and therefore become less activated (4).…”

Ambulatory anesthesia in plastic surgery: opportunities and challenges

“…52 Furthermore, liposomal bupivacaine can provide up to 72 hours of local pain relief and has proven safety and efficacy. 53 A study of liposomal bupivacaine injection performed as a regional block in abdominoplasty with rectus plication found that patients experienced reduced postoperative pain, required less postoperative narcotic medication, and resumed both earlier ambulation and normal activity compared to controls.…”