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The effect of warming local anaesthetics on pain of infiltration

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Report by J Sultan, ST1 Accident and Emergency

Checked by Andrew J Curran, Consultant Accident and Emergency

Abstract

A short cut review was carried out to establish whether warming local anaesthetic solutions reduced the pain on injection. A total of 758 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are presented in table 4. The clinical bottom line is that warming local anaesthetics, either alone or in combination with buffering, significantly reduces pain of local infiltration.

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Table 4

Three part question

In [patients requiring local anaesthetic infiltration] is [warmed local anaesthetic rather than room temperature local anaesthetic] on infiltration [less painful]?

Clinical scenario

A 40-year-old man sustains a 2 cm laceration to his left forearm. There is no tendon/neurovascular damage. Would warmed local anaesthetic or room temperature local …

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