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Reducing the Pain of Local 1% Lidocaine Infiltration with a Preceding Bacteriostatic Saline Injection

A Double-blind Prospective Trial

Stephen L. Barrett DPM, MBA1, Jim Maxka PhD, DPM1, Jamie N. Mieras DPM1, and Kimbal E. Cooper PhD2
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  • 1 Arizona School of Podiatric Medicine, Midwestern University, Glendale, AZ
  • | 2 Biomedical Sciences Program, Midwestern University, Glendale, AZ
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Background:

Lidocaine injection for local anesthesia is a common podiatric medical procedure. We tested the hypothesis that injection of bacteriostatic saline solution containing 0.9% benzyl alcohol before the lidocaine infiltration can reduce the burning caused by lidocaine injection.

Methods:

This double-blind prospective trial involved 45 participants who each received four injections in two areas of the dorsum of the foot and rated the perceived pain on a visual analog scale. The order of the injections was designed to disguise the control and intervention arms of the study.

Results:

The sensation of the lidocaine injection after the injection of saline was reduced significantly (P = .028). The percentage of lidocaine injections with visual analog scale scores of 0 increased by 36% after preinjection with bacteriostatic saline solution containing 0.9% benzyl alcohol.

Conclusions:

The fact that 40% of the intervention visual analog scale pain scores for lidocaine injections were 0 suggests that a near painless lidocaine injection technique is an achievable goal and that the present technique is a simple and inexpensive method of reducing the pain of lidocaine injections. (J Am Podiatr Med Assoc 101(3): 223–230, 2011)

Corresponding author: Stephen L. Barrett, DPM, Arizona School of Podiatric Medicine, Midwestern University, 19555 N 59th Ave, Glendale, AZ 85308. (E-mail: sbarre@midwestern.edu)