City Hospital, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
Clin Exp Dermatol. 2022 Oct;47(10):1781-1793. doi: 10.1111/ced.15277. Epub 2022 Jul 15.
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.
在皮肤科手术中，有多种局部麻醉（LA）的辅助手段，也有许多方法可以减轻 LA 的疼痛。本综述旨在总结与这些辅助手段和减轻 LA 疼痛的方法相关的证据。LA 的辅助手段可以是优化麻醉效果的重要考虑因素。目前的证据表明，缓冲和加热 LA 液，以及对皮肤进行冷却、捏压和振动，在给药时可有效减轻疼痛。在本综述中，皮肤冷却和振动对减轻疼痛没有显著差异。研究表明，总体而言，LA 注射到远端部位是安全的。然而，就皮肤科手术而言，关于如何减轻 LA 注射时的疼痛以及确定 LA 在有信心的远端部位的安全性方面，证据有限。需要进一步开展高质量的以多中心随机对照试验形式的研究。
