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Anesth Analg 2002;94:351-354
© 2002 International Anesthesia Research Society

AMBULATORY ANESTHESIA

Chloroprocaine is Less Painful than Lidocaine for Skin Infiltration Anesthesia

Livia S. Marica, MD, Terry O’Day, BS, Janine E. Janosky, PhD, and Elisabet U. M. Nystrom, MD, PhD

Department of Anesthesiology, The Western Pennsylvania Hospital, Pittsburgh, Pennsylvania

Address correspondence and reprint requests to Livia S. Marica, MD, Department of Anesthesiology, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Suite 459, Pittsburgh, PA 15224. Address e-mail to Livia181{at}aol.com

Skin infiltration of local anesthetics causes pain. In a double-blinded protocol, 22 volunteers received random intradermal injections to the volar surface of the forearm with each of the following solutions: normal saline solution 0.9% (NSS), lidocaine 1% (L), lidocaine 1% and sodium bicarbonate 8.4% (L+BIC), 2-chloroprocaine 2% (CP), 2-chloroprocaine 2% and sodium bicarbonate 8.4% (CP+BIC), and NaCHO3 8.4% (BIC). Initially, each volunteer received an open-labeled injection of NSS. A 100-mm visual analog scale (VAS, 1–100) was used to assess pain with each injection. The pH of each solution was stable for the length of the study. Repeated measures of variance were used for analysis. The VAS scores (mean ± SD) for open-label and blinded NSS injections were 15.5 ± 15.9 and 14.0 ± 18.1, respectively. The scores for the studied solutions were as follows: BIC, 47.2 ± 25.5; L, 25.8 ± 27.6; L+BIC, 16.0 ± 14.2; CP, 8.6 ± 7.4; and CP+BIC, 6.8 ± 6.7. No significant difference was found between CP and alkalinized CP, but the injection of both solutions was significantly less painful than that of all other solutions (P < 0.05). The pH of the solutions was not related to the pain score. We found that chloroprocaine caused less pain at injection than the more commonly used lidocaine.

IMPLICATIONS: Using 2-chloroprocaine can diminish pain caused by the intradermal injection of lidocaine. pH variations of the solution did not relate to the pain profile of the local anesthetic.




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[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.