This study compared the pain from intradermal infiltration of (1) plain lidocaine, (2) warmed lidocaine, (3) buffered lidocaine, and (4) warmed, buffered lidocaine. A randomized, double-blind, Latin Square design of 20 volunteers was used. Each volunteer was injected with a series of four test solutions on four separate occasions, for 16 total injections each. Each volunteer served as his or her own control. The mean pain scores for the four solutions were: 44.2 for plain lidocaine, 42.2 for warmed lidocaine, 36.7 for buffered lidocaine, and 29.2 for warmed, buffered lidocaine. Buffered lidocaine was statistically less painful than both plain lidocaine and warmed lidocaine. Warmed, buffered lidocaine was significantly less painful than all other solutions, including buffered lidocaine (P < .005). However, warmed lidocaine did not yield pain scores significantly different from plain lidocaine. In this experimental model, warmed lidocaine was not superior to plain lidocaine, but warmed, buffered lidocaine caused significantly less pain than plain lidocaine, buffered lidocaine, or warmed lidocaine. Thus, there may be benefit from heating the buffered lidocaine now in common clinical use.

Pain reduction in lidocaine administration through buffering and warming

The performance of different disposable needle syringe systems was determined by measuring needle-puncture pain, needle-bending forces, and the fluid dynamics of the systems. Thirty-gauge needles cause less needle-puncture pain than any other needle. The force required to bend the 30-gauge needle irreversibly was lower than that for the other needles. Studies of the fluid dynamics of different needle syringe assemblies demonstrated that the flow rate can be limited by using large-size syringes (30 mL) and needles with the smallest internal diameter. On the basis of the results of this study, 30-gauge needles attached to 10-mL syringes are recommended for infiltration anesthesia, and 25-gauge needles with 10-mL syringes are advocated for regional nerve blocks. In infiltration anesthesia, the local anesthetic agent should be injected slowly into the subdermal tissue over a 10-second period. When performing regional nerve blocks, it is also advisable to inject the local anesthetic agent over a 10-second time interval.

Performance of disposable needle syringe systems for local anesthesia.

Amac:Lokal anestezik ajanlar dis hekimliginde uzun yillardan beri yaygin olarak kullanilmaktadir.  Lokal anesteziklerin vucut sicakliginda uygulanmasinin anestezi suresini kisalttigi ve injeksiyon sirasinda agriyi azalttigi rapor edilmistir. Bu calismanin amaci; yirmi yas disi cekimi oncesinde isitilmis lokal anestezik solusyonun etkisinin injeksiyon sirasinda duyulan agri ve anestezinin gerceklesme suresi acisindan karsilastirilmasidir. Gerec ve Yontem: Yirmi yas disi cekimi gerceklestirilecek kirk alti yetiskin hasta bu split-mouth calismaya dahil edilmistir. Hastalarin bir tarafina isitilmis lokal anestezik solusyon diger tarafina ise oda sicakliginda anestezik solusyon injekte edilmistir.  Bulgular: Ortalama anestezi gerceklesme suresi ve injeksiyon sirasinda alinan VAS degerleri acisindan iki grup arasinda anlamli fark bulunamamistir. Hastalarda injeksiyon sirasinda ve sonrasinda herhangi bir komplikasyon gorulmemistir.  Sonuc: Isitilmis anestezinin etkinliginin degerlendirilmesi acisindan daha cok sayida ornegin yer aldigi ileriki calismalara ihtiyac vardir.

/pdf/effect-of-warming-of-local-anesthesia-on-pain-and-anesthesia-2xo1rh0pbe.pdf

Effect of warming of local anesthesia on pain and anesthesia duration before wisdom tooth extraction

background The tumescent technique of local anesthesia has been accepted as the standard of care for liposuction surgery. Large volumes of a dilute solution of lidocaine, epinephrine, sodium bicarbonate, and triamcinolone are infused into the subcutaneous fat. The technique eliminates the need for general anesthesia and provides greater safety and improved esthetic results.



objective A study was designed to evaluate the benefit of wanning of the local anesthetic to 40°C prior to infiltration and thus to determine whether warming provides improved patient comfort.



methods A double-blind randomized cross-over study was performed in 16 patients undergoing outpatient tumescent liposuction. Pain scores were determined using a visual analog pain scale.



results The mean pain score was significantly lower for areas treated with the 40°C warmed solution.



conclusion Warming of local anesthetic solution for tumescent liposuction significantly reduces pain as perceived by the patient and is recommended in all tumescent liposuction surgery.

Comparison of room temperature and warmed local anesthetic solution for tumescent liposuction : A randomized double-blind study

The purpose of the study was to determine whether local anesthetic solution warmed to body temperature (37° C) produced less pain on injection than an anesthetic solution injected at room temperature (21° C) and to determine which solution resulted in quicker anesthetic onset. It was found that the subjects experienced no difference in pain during injection of warm and cold anesthetic solution given respectively in the maxillary buccal sulcus area. The time of anesthetic onset was also not influenced by solution temperature.

Pain sensation related to local anesthesia injected at varying temperatures.

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Pain sensation related to local anesthesia injected at varying temperatures.