Lidocaine administration techniques for head and limb wound anesthesia: Injection vs. topical application

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2025-02-19 DOI:10.1016/j.pcorm.2025.100483

Samad Shams Vahdati , Alireza Ala , Mohammad Mirza-aghazadeh attari , Paria Habibollahi , Arezoo Fathalizadeh , Behrang Khaffafi , Saba Mehrtabar

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引用次数: 0

Abstract

Purpose

Lidocaine is one of the most utilized anesthetics used in different forms and various clinical contexts. Recently there have been controversy about the best method of lidocaine administration and there have been studies comparing subcutaneous and topical lidocaine in different clinical fields. The present study aims to compare the effect of topical and subcutaneous injection of lidocaine in patients presenting with ulcerations in their head and extremities.

Methods

This single-center cross-sectional study, conducted from April 2016 to April 2017 at Imam Reza Medical Educational Center, Tabriz, Iran, included patients with extremity lacerations under 3 cm, excluding cases with bites, joint or ear injuries, specific medications, cardiac or neuropathic histories, and epilepsy. Ethical approval and informed consent were obtained. Data were collected via questionnaires by trained interviewers. Patients received either topical or subcutaneous lidocaine as per clinical practice, without randomization. Pain was measured using a 100-mm visual analogue scale (VAS). Data analysis utilized SPSS v22.0, with significance set at p < 0.05 and 80 % study power.

Results

In this observational study of 305 patients, 162 received subcutaneous lidocaine and 143 received topical lidocaine. No significant differences in age or gender were found (P = 0.25 and P = 0.86). Patients with topical lidocaine reported higher starting pain, while those receiving subcutaneous lidocaine experienced significantly more pain during administration and suturing (P < 0.05), highlighting the impact of lidocaine application methods on patient pain experiences.

Conclusion

The difference in pain during administration between the two methods was statistically and clinically significant, while the difference in pain during suturing was statistically significant but not clinically meaningful. These findings suggest that topical lidocaine offers a less painful alternative to subcutaneous injection, particularly during administration.

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.