title: Reducing the pain of local 1% lidocaine infiltration with a preceding bacteriostatic saline injection: a double-blind prospective trial.
abstract: 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.
authors.affiliation: Arizona School of Podiatric Medicine, Midwestern University, Glendale, AZ 85308, USA. sbarre@midwestern.edu
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Barrett
authors.forename: Jim
authors.initials: J
authors.lastname: Maxka
authors.forename: Jamie N
authors.initials: JN
authors.lastname: Mieras
authors.forename: Kimbal E
authors.initials: KE
authors.lastname: Cooper
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019905:Benzyl Alcohol / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005528:Foot; D006801:Humans; D007271:Injections, Intradermal / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D019905:Benzyl Alcohol