Local anaesthetics in dermatological surgery : a review of adjuncts and pain reduction techniques
Yannoulias, Basil Gnanappiragasam, Dushyanth Veitch, David
Yannoulias, Basil
Gnanappiragasam, Dushyanth
Veitch, David
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Affiliation
Sandwell and West Birmingham NHS Trust; The Royal Wolverhampton NHS Trust; Leicester University Hospitals NHS Trust; Walsall Healthcare NHS Trust
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Publication date
2022-07-15
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Abstract
A variety of adjuncts for local anaesthesia (LA) exists for dermatological surgery, along with many options to reduce the pain of LA. This review aims to summarize the evidence relating to such adjuncts and methods to reduce the pain of LA. Adjuncts to LA can be an important consideration to optimize anaesthetic effect. Current evidence suggests that buffering and warming of LA fluid, along with cooling, pinching and administering vibrations to the skin are effective at reducing pain during administration. In this review, no significant difference in pain reduction was found between cooling and administering vibrations to the skin. Studies demonstrate that, overall, LA injection into distal sites is safe. However, the evidence specific to dermatological surgery is limited with regard to ways to reduce pain during LA injection and in determining the safety of LA for distal sites with confidence. Further high-quality research in the form of multicentre randomized controlled trials is required.
Citation
Charalambides M, Yannoulias B, Gnanappiragasam D, Veitch D, Wernham A. Local anaesthetics in dermatological surgery: a review of adjuncts and pain reduction techniques. Clin Exp Dermatol. 2022 Oct;47(10):1781-1793.
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Article