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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


A short cut review was carried out to establish whether warming local anaesthetic solution reduced the pain of infiltration. A total of 720 papers were found using the reported searches, of which 11 presented 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 2. It is concluded that warmed local anaesthetic solution is less painful than that at room temperature.

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Table 2

Three-part question

In [patients requiring local anaesthetic infiltration] is [infiltration of warmed or room temperature solution] [less painful]?

Clinical scenario

A 40-year-old man attends the emergency department, having sustained a 2 cm laceration to his left forearm. There is no tendon/neurovascular damage. He tells you that he has a real phobia of needles and asks if you can make sure it doesn’t hurt when you …

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