Abstract
The injection of local anaesthetic solutions is frequently a painful and unpleasant experience for patients. A double-masked randomised controlled trial was performed to study the potential benefit of warming lignocaine during local anaesthetic minor surgical procedures on the eyelids. The pain of subcutaneous injection of 1.5 ml of 2% lignocaine at room temperature (cold) and body temperature (warm) was compared in 60 patients during the surgical incision of solitary meibomian cysts of one eyelid. Patients were randomly allocated to receive either warm or cold lignocaine. Pain was assessed subjectively by the use of a linear analogue pain scale ranging from 0 to 100. The median pain score for the group receiving cold anaesthetic (19.5) was found to be greater than that for the warm group (10.0; p = 0.02). In conclusion, the simple process of warming lignocaine to 37 °C was found to reduce the pain associated with its injection significantly. It is recommended that this technique be more widely adopted in order to minimise patients' discomfort.
Similar content being viewed by others
Article PDF
References
Morris RW, Whish DKM . A controlled trial of pain on skin infiltration with local anaesthetics. Anaesth Intensive Care 1984;12:113–4.
Morris R, McKay W, Mushlin P . Comparison of pain associated with intradermal and subcutaneous infiltration with various local anaesthetic solutions. Anaesth Analg 1987;66:1180–2.
Davidson JAH, Bloom SJ . Warming lignocaine to reduce pain associated with injection. BMJ 1992;305:617–8.
Cragg AH, Berbaum K, Smith TP . A prospective blinded trial of warm and cold lidocaine for intradermal injection. AJR 1988;150:1183–4.
Bainbridge LC . Comparison of room temperature and body temperature local anaesthetic solutions. Br J Plast Surg 1991;44:147–8.
Boggia R . Heating local anaesthetic cartridges. Br Dent J 1967;122:287.
Dalton AM, Sharma A, Redwood M, Wadsworth J, Touquet R . Does the warming of local anaesthetic reduce the pain of its injection? Arch Emerg Med 1989;6:247–50.
Kaplan PA, Lieberman RP, Vonk BM . Does heating lidocaine decrease the pain of injection? AJR 1987;148:1291.
Gormley DE . Local anaesthesia: pain control with proper injection technique. J Dermatol Surg Oncol 1987;1:13, 35-6.
Ritchie JM, Greengard P . On the active structure of local anaesthetics. J Pharmacol Exp Ther 1961;133:241–5.
Kamaya H, Hayes JJ, Ueda I . Dissociation constants of local anaesthetics and their temperature dependence. Anaesth Analg 1983;62:1025–30.
Christoph RA, Buchanan L, Begalla K, Schwartz S . Pain reduction in local anaesthetic administration through pH buffering. Ann Emerg Med 1988;17:117–20.
Martin AJ . pH adjustment and discomfort caused by the intradermal injection of lignocaine. Anaesthesia 1990;45:975–8.
Bonhomme L, Benhamou D, Martre H, Preaux N . Chemical stability of bupivacaine and epinephrine in pH adjusted solutions. Anaesthesiology 1987;67:A279.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bell, R., Butt, Z. & Gardner, R. Warming lignocaine reduces the pain of injection during local anaesthetic eyelid surgery. Eye 10, 558–560 (1996). https://doi.org/10.1038/eye.1996.129
Issue Date:
DOI: https://doi.org/10.1038/eye.1996.129
Keywords
This article is cited by
-
Evaluation of effect of warm local anesthetics on pain perception during dental injections in children: a split-mouth randomized clinical trial
Clinical Oral Investigations (2020)
-
Understanding and Minimising Injection-Site Pain Following Subcutaneous Administration of Biologics: A Narrative Review
Rheumatology and Therapy (2020)
-
Prilocaine versus lignocaine for minor lid procedures
Eye (2000)