• Stephen L Barrett, Jim Maxka, Jamie N Mieras, and Kimbal E Cooper.
• Arizona School of Podiatric Medicine, Midwestern University, Glendale, AZ 85308, USA. sbarre@midwestern.edu
• J Am Podiatr Med Assoc. 2011 May 1;101(3):223-30.

BackgroundLidocaine 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.MethodsThis 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.ResultsThe 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.ConclusionsThe 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.

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