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Injection of local anesthetics causes pain at the injection site before providing anesthesia. Postulated methods to mitigate this pain include slowing the rate of injection; avoiding epinephrine, when possible; buffering; and warming the local anesthetic to body temperature prior to injection. These authors assessed injection pain in a meta-analysis of 18 randomized studies involving 831 patients who received either warmed (body temperature) or unwarmed (room temperature) subcutaneous or intradermal local anesthetic injections. The anesthetic was unbuffered in ten studies.
Patients reported pain on either visual analog or numeric rating scales. Methods of warming included waterbaths, incubators, fluid warmers, baby food warmers, warming tray…