Biomaterial Database

Local anesthesia for lacerations: pain of infiltration inside vs outside the wound. 1998

J M Bartfield, and S J Sokaris, and N Raccio-Robak

Department of Emergency Medicine, Albany Medical Center, NY 12208, USA. joel_bartfield@ccgateway.amc.edu

OBJECTIVE To compare the pains of infiltration of a local anesthetic for simple lacerations when used from within the wound vs through intact skin. METHODS A randomized, prospective, single-blind, experimental protocol was conducted on a convenience sample of adults with simple lacerations. Subjects received two 0.5-mL injections of buffered lidocaine in each of the sites being compared. Immediately following each injection, pain was measured using a visual analog pain scale. Pain scores were converted to a numerical score and analyzed by a Wilcoxon signed-rank test. Subjects also were asked which injection hurt more, the first or the second (analyzed by a chi2 test). RESULTS A total of 63 subjects were enrolled. The first injection was within the wound and the second injection through intact skin (group 1) for 32 patients, and the order was reversed for 31 patients (group 2). Median pain scores for all inside-the-wound injections (14 mm) were lower than those with intact skin injections (37 mm; p < 0.0001). In group 1, 4 subjects reported the first injection (within wound) hurt most, 23 thought the second (intact skin) hurt most, and 5 found no difference. In group 2, 18 subjects reported the first injection (intact skin) hurt most, 5 believed the second injection (within wound) hurt most, and 8 found no difference, p < 0.0001. CONCLUSIONS Local anesthesia is less painful when injected from within a laceration as compared with intact skin.

UI	MeSH Term	Description	Entries
D008012	Lidocaine	A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.	Lignocaine,2-(Diethylamino)-N-(2,6-Dimethylphenyl)Acetamide,2-2EtN-2MePhAcN,Dalcaine,Lidocaine Carbonate,Lidocaine Carbonate (2:1),Lidocaine Hydrocarbonate,Lidocaine Hydrochloride,Lidocaine Monoacetate,Lidocaine Monohydrochloride,Lidocaine Monohydrochloride, Monohydrate,Lidocaine Sulfate (1:1),Octocaine,Xylesthesin,Xylocaine,Xylocitin,Xyloneural
D008297	Male		Males
D010147	Pain Measurement	Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.	Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D002021	Buffers	A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer.	Buffer
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D014947	Wounds and Injuries	Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.	Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound