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J Dermatol Surg Oncol. 1993 Mar;19(3):237-40.

Less painful alternatives for local anesthesia.

Author information

1
Department of Dermatology, University of Puerto Rico School of Medicine, San Juan 00936-5067.

Abstract

BACKGROUND:

Infiltration of commonly used local anesthetics is painful. It has been speculated that the pain on infiltration is a direct consequence of the acidity of the anesthetic solution.

OBJECTIVE:

To compare the degree of pain of intradermal infiltration and the duration of anesthesia for 1% lidocaine with epinephrine 1:100,000, 1% lidocaine with epinephrine 1:100,000 with 80 meq/L sodium bicarbonate, bacteriostatic saline solution with 1% lidocaine with epinephrine 1:300,000, and bacteriostatic saline solution with 1% lidocaine with epinephrine 1:100,000.

METHODS:

The study was performed in three phases: 1) double-blind comparison study, 2 and 3) open clinical trials.

RESULTS:

Bacteriostatic saline solution with epinephrine 1:300,000 is significantly less painful on intradermal infiltration than lidocaine with epinephrine 1:100,000 with sodium bicarbonate 80 meq/mL. The saline preparation is an effective anesthetic alternative for superficial surgical procedures such as shave and scissors excision, light curettage and electrodesiccation, and superficial CO2 laser vaporization.

CONCLUSION:

The pH values of bacteriostatic saline solution with epinephrine 1:300,000 and lidocaine with epinephrine diluted with bacteriostatic saline solution are 5.3 and 4.2, respectively. Both were found to be less painful than 1% lidocaine with epinephrine with sodium bicarbonate 84 meq/mL, which had a pH of 7.4. It is unlikely that the pain of infiltration is a simple function of the pH of the anesthetic solution.

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PMID:
8383150
[Indexed for MEDLINE]

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