Virtually Painless Local Anesthesia: Diluted Lidocaine Proves to Be Superior to Buffered Lidocaine for Subcutaneous Infiltration

October 2012 | Volume 11 | Issue 10 | Original Article | 39 | Copyright © October 2012


Martin Zaiac MD,e Shino Bay Aguilera DO,a Larissa Zaulyanov-Scanlan MD,b Caroline Caperton MD BS MSPH,d Stacy Chimento MDc

aWellington Regional Medical Center/Lake Erie University, Wellington, FL bUniversity of Miami Department of Dermatology, Miami, FL cUniversity of Miami Miller School of Medicine, Department of Dermatology and Subcutaneous Surgery, Miami, FL dUniversity of Miami Miller School of Medicine, Miami, FL eGreater Miami Skin and Laser Center and Florida International University, Miami, FL

community-based hospital. Although we cannot state with certainty why our combination is more effective, we suspect that it is mostly due to the alteration of PKA.

CONCLUSION

Our results demonstrate that diluted lidocaine is superior to traditionally buffered lidocaine for pain attenuation during subcutaneous infiltration. We have found this mixture to be superior when obtaining skin biopsies, either by the punch or the shave technique. In addition, we recommend this mixture as a preanesthetic before more extensive procedures such as Mohs micrographic surgery or formal excisions, where long-lasting anesthetics such as bupivacaine would need to be added. Another benefit of this technique is that the mixture of lidocaine with normal saline is more cost-effective than either lidocaine buffered with sodium bicarbonate or lidocaine alone.

DISCLOSURES

The authors have no relevant conflicts of interest to disclose.

ACKNOWLEDGMENTS

The authors gratefully acknowledge Fuquan Lin MD for his assistance with the statistical data analysis within this article.

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ADDRESS FOR CORRESPONDENCE

Martin N. Zaiac MDGreater Miami Skin and Laser Center4302 Alton Rd, Ste # 1005Miami Beach, FL 33140Phone: (305) 532-4478Fax: (305) 532-9753DrMartyZ@aol.com
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