Warm and neutral tumescent anesthetic solutions are essential factors for a less painful injection.
BACKGROUND
Tumescent local anesthesia is widely used in dermatologic surgery. Minimizing pain associated with injections is crucial to successful surgical procedures.


OBJECTIVE
This study investigates the pain associated with warm and room temperatures in neutralized or nonneutralized tumescent anesthetic solutions injection.


METHODS
Thirty-six patients with axilla osmidrosis who underwent local anesthesia for surgery were randomly assigned to three groups. Group A received warm neutral (40 degrees C) and room-temperature neutral (22 degrees C) tumescent injections to each axillary region. Group B received warm neutral (pH 7.35) and warm nonneutral (pH 4.78) tumescent injections on each side of axilla. Group C received warm nonneutral and room-temperature nonneutral tumescent injections on each side of axilla. Pain associated with infiltration of anesthesia was rated on a visual analog scale (VAS).


RESULTS
A statistically significant decrease (p < .001) in pain sensation was reported on the warm, neutral injection side (mean rating, 32.7 mm) compared with the room-temperature, neutral injection side (mean rating, 53.3 mm). Patient-reported pain intensity was significantly lower on the side that received warm, neutral tumescent anesthesia (mean rating, 26.8 mm) than on the side receiving warm, nonneutral tumescent anesthesia (mean rating, 44.9 mm; p < .001). The difference in VAS scores between warm neutral (mean rating, 23.9 mm) and room-temperature nonneutral (mean rating, 61.2 mm) was statistically significant (p < .001).


CONCLUSIONS
The warm, neutral tumescent anesthetic preparation effectively suppressed patient pain during dermatologic surgical procedures.
Yang
Chih-Hsun
CH
Department of Dermatology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Hsu
Hsiu-Cheng
HC
Shen
Su-Chin
SC
Juan
Wei-Hsin
WH
Hong
Hong-Shang
HS
Chen
Chien-Hsun
CH
D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001365:Axilla; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D015187:Lipectomy / Q000379:methods; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D012189:Retrospective Studies; D013696:Temperature; D016896:Treatment Outcome
D000779:Anesthetics, Local