Pain of Local Anesthetics: Rate of Administration and Buffering

Scarfone, Richard J.; Jasani, Melinda; Gracely, Edward J.

doi:10.1016/s0196-0644(98)70278-1

Cited by 146 publications

(77 citation statements)

References 16 publications

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“…(10) In the present study, we used the perianal block technique, which Nystrom et al (5) Arndt et al (15) reported that rapid injection hurts more than slow infiltration. Scarfone et al (16) suggested that a slower injection rate is associated with less pain because of less rapid distention of local tissue and activation of fewer nerve endings. In our study, a narrow 25-gauge needle was fitted with a large volume syringe and 40 ml of ropivacaine was administered by eight columns of 5 ml each over the period of a few minutes.…”

Section: Discussionmentioning

confidence: 99%

Local Perianal Block in Anal Surgery: The Disadvantage of Pain during Injection despite High Patient Satisfaction

et al. 2010

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Purpose:We evaluated the usefulness of anal surgery using local perianal block and assessed patient satisfaction. Methods: From January to October 2008, a total of 41 consecutive patients consented to anal operation with local perianal block for stapled hemorrhoidopexy (n=15), excisional hemorrhoidectomy (n=9), fistulotomy (n=13), or abscess drainage (n=4). Postoperative pain was evaluated on a visual analogue scale (VAS) from 0 to 10. Patient satisfaction was evaluated through telephone interviews. Results:The mean peak VAS scores on the day of operation were 3.3 after stapled hemorrhoidopexy, 2.9 after excisional hemorrhoidectomy, 2.6 after fistulotomy, and 3.5 after abscess drainage; on postoperative day 1, the scores were 1.3, 1, 0.9, and 2.3, respectively. The majority of patients (31; 86.1%) were satisfied with the postoperative results (very satisfied 12, satisfied 19, only fair 5, unsatisfied 0). More than half of the patients (23; 63.9%) were satisfied with the use of local anesthesia (very satisfied 4, satisfied 19, only fair 12, unsatisfied 1). The mean VAS scores during injection were significantly different between the satisfied group (very satisfied and satisfied) and not-satisfied group (only fair and unsatisfied) treated with the local anesthesia (satisfied group: 3.5 and not-satisfied group: 5.4, P=0.04). Most patients (30; 83.3%) would undergo this anesthetic procedure again if future anal surgeries were necessary. Conclusion: Local perianal block is feasible for various anal operations and results in a high degree of satisfaction among patients. However, the pain associated with injection has an adverse effect on patient satisfaction. (J Korean Surg Soc 2010;78:106-110)

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Section: Discussionmentioning

confidence: 99%

Local Perianal Block in Anal Surgery: The Disadvantage of Pain during Injection despite High Patient Satisfaction

et al. 2010

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“…Whereas a multitude of investigators have championed other techniques such as altering the rate of infiltration [14,36], distraction methods, buffering [16-19, 37, 38] and warming the anaesthetic agents [39][40][41][42] in a variety of settings, there is no clear consensus as to the best method to reduce infiltrative pain, as no-one has sought to combine all these techniques in a prospective randomised study. Some studies have demonstrated that warm buffered anaesthetic agents induce less pain during infiltration than either warmed or buffered agents used in isolation, and that buffering solutions is preferable to warming the anaesthetic agents [9,12,13].…”

Section: Discussionmentioning

confidence: 99%

“…These include application of topical analgesics such as amethocaine [10], distraction techniques [11], counter irritation [12], warming the anaesthetic agents [13], varying rates of infiltration [14] and buffering the local anaesthesia [9,[15][16][17][18][19].…”

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confidence: 99%

The effect of local cooling on pain perception during infiltration of local anaesthetic agents, a prospective randomised controlled trial*

Leff

Nortley²,

Dang³

et al. 2007

Anaesthesia

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SummaryThe effect of pre‐infiltration local cooling of the site of inguinal herniorrhaphy on pain perception during infiltration of local anaesthetic was studied in a prospective randomised controlled trial. One hundred patients were randomly allocated to receive topical application of either a cooled saline bag (study group) or a saline bag at room temperature (control group) prior to injection of local anaesthetic. Pain scores were recorded using a visual analogue scale following application of the saline bags and again on completion of infiltration with local anaesthetic. There was no significant difference in pain scores following topical saline bag application. However, a highly significant difference (p = 0.0001, Mann–Whitney U) was observed between post‐infiltration pain scores of the study group (median = 2) and the control group (median = 6).

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“…Slow infiltration reduces pain from lidocaine infiltration. 121 Although there are no available data on the use of opioids before or after chest-tube insertion for pain prevention, this seems to be a reasonable approach. Nonpharmacologic means of reducing pain in neonates should be used also.…”

Section: Intercostal Drainsmentioning

confidence: 99%

Prevention and Management of Pain in the Neonate: An Update

2006

Pediatrics

409

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The prevention of pain in neonates should be the goal of all caregivers, because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in our knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor yet painful procedures. Every health care facility caring for neonates should implement an effective pain-prevention program, which includes strategies for routinely assessing pain, minimizing the number of painful procedures performed, effectively using pharmacologic and nonpharmacologic therapies for the prevention of pain associated with routine minor procedures, and eliminating pain associated with surgery and other major procedures. INTRODUCTION ObjectivesThis updated statement is intended for health care professionals who care for neonates (preterm to 1 month of age). The objectives are to:1. emphasize that despite increased awareness of the importance of pain prevention, neonates in the NICU continue to be exposed to numerous painful minor procedures daily as part of their routine care;2. present objective means of assessing neonatal pain by health care professionals;3. describe effective strategies to prevent and treat pain associated with routine minor procedures; and 4. review appropriate methods to prevent and treat pain associated with surgery and other major procedures. BackgroundThe prevention of pain in neonates is an expectation of parents. 1 However, there are major gaps in our knowledge regarding the most effective way to accomplish this. Although it may not be possible to completely eliminate pain in neonates, much can be done to reduce the amount and intensity of pain. The prevention of www.pediatrics.org/cgi

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Pain of Local Anesthetics: Rate of Administration and Buffering

Cited by 146 publications

References 16 publications

Local Perianal Block in Anal Surgery: The Disadvantage of Pain during Injection despite High Patient Satisfaction

Local Perianal Block in Anal Surgery: The Disadvantage of Pain during Injection despite High Patient Satisfaction

The effect of local cooling on pain perception during infiltration of local anaesthetic agents, a prospective randomised controlled trial*

Prevention and Management of Pain in the Neonate: An Update

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