Minimizing the pain of local anesthesia injection.

Abstract:

BACKGROUND:Local anesthetic injection is often cited in literature as the most painful part of minor procedures. It is also very possible for all doctors to get better at giving local anesthesia with less pain for patients. The purpose of this article is to illustrate and simplify how to inject local anesthesia in an almost pain-free manner. METHODS:The information was obtained from reviewing the best evidence, from an extensive review of the literature (from 1950 to August of 2012) and from the experience gained by asking over 500 patients to score injectors by reporting the number of times they felt pain during the injection process. RESULTS:The results are summarized in a logical stepwise pattern mimicking the procedural steps of an anesthetic injection-beginning with solution selection and preparation, followed by equipment choices, patient education, topical site preparation, and finally procedural techniques. CONCLUSIONS:There are now excellent techniques for minimizing anesthetic injection pain, with supporting evidence varying from anecdotal to systematic reviews. Medical students and residents can easily learn techniques that reliably limit the pain of local anesthetic injection to the minimal discomfort of only the first fine needlestick. By combining many of these conclusions and techniques offered in the literature, tumescent local anesthetic can be administered to a substantial area such as a hand and forearm for tendon transfers or a face for rhytidectomy, with the patient feeling just the initial poke.

journal_name

Plast Reconstr Surg

authors

Strazar AR,Leynes PG,Lalonde DH

doi

10.1097/PRS.0b013e31829ad1e2

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

675-684

issue

3

eissn

0032-1052

issn

1529-4242

pii

00006534-201309000-00030

journal_volume

132

pub_type

杂志文章,评审
  • Body Dysmorphic Disorder in Patients Seeking Abdominoplasty, Rhinoplasty, and Rhytidectomy.

    abstract:BACKGROUND:Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. METHODS:Three hundred patie...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000475753.33215.8f

    authors: de Brito MJA,Nahas FX,Cordás TA,Tavares H,Ferreira LM

    更新日期:2016-02-01 00:00:00

  • A Novel Model for Cutaneous Wound Healing and Scarring in the Rat.

    abstract:BACKGROUND:Current rodent models of wound healing and scarring are flawed because of rapid wound contraction and inconspicuous scarring after healing, which is not closely parallel to the physiologic process in humans. This study aimed to establish a novel model of wound healing and scarring in rats. METHODS:Excisiona...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005274

    authors: Zhou S,Wang W,Zhou S,Zhang G,He J,Li Q

    更新日期:2019-02-01 00:00:00

  • Preoperative imaging for DIEA perforator flaps: a comparative study of computed tomographic angiography and doppler ultrasound.

    abstract:BACKGROUND:Abdominal donor-site flaps, including the transverse rectus abdominis musculocutaneous (TRAM) and deep inferior epigastric artery (DIEA) perforator flaps, are standard in autologous breast reconstruction. With significant variation in the vascular anatomy of the abdominal wall, preoperative imaging is essent...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Rozen WM,Phillips TJ,Ashton MW,Stella DL,Gibson RN,Taylor GI

    更新日期:2008-01-01 00:00:00

  • Anatomical Basis of the Gastroepiploic Vascularized Lymph Node Transfer: A Radiographic Evaluation Using Computed Tomographic Angiography.

    abstract:BACKGROUND:The omentum, nourished by the gastroepiploic vessels, has gained popularity as an option for vascularized lymph node transfer. The anatomy of the gastroepiploic vessels, omentum, and lymph nodes has not been investigated. The purpose of this article is to describe the right gastroepiploic artery and related ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004772

    authors: Howell AC,Gould DJ,Mayfield C,Samakar K,Hassani C,Patel KM

    更新日期:2018-10-01 00:00:00

  • Detection of Perforators for Free Flap Planning Using Smartphone Thermal Imaging: A Concordance Study with Computed Tomographic Angiography in 120 Perforators.

    abstract::Design and preoperative planning of microsurgical flaps are fundamental steps for successful surgery. Currently, computed tomographic angiography is considered the gold standard, and new technologies such as thermography could complement its usefulness. The aim of this study was to determine the concordance between th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004126

    authors: Pereira N,Valenzuela D,Mangelsdorff G,Kufeke M,Roa R

    更新日期:2018-03-01 00:00:00

  • Certification examination cases of candidates for certification by the American Board of Plastic Surgery: trends in practice profiles spanning a decade (2000 to 2009).

    abstract:BACKGROUND:The purpose of this study was to evaluate the case mix of plastic surgeons in their early years of practice by examining candidate case logs submitted for the oral examination. METHODS:Deidentified data from 2000 to 2009 consisting of case logs submitted by young plastic surgery candidates for the oral exam...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31821b6307

    authors: Chung KC,Song JW,Shauver MJ,Cullison TM,Noone RB,Directors of the American Board of Plastic Surgery.

    更新日期:2011-08-01 00:00:00

  • Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.

    abstract::The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200111000-00011

    authors: Muzaffar AR,Byrd HS,Rohrich RJ,Johns DF,LeBlanc D,Beran SJ,Anderson C,Papaioannou aA A

    更新日期:2001-11-01 00:00:00

  • Osteoblastic and osteoclastic activation in coronal sutures undergoing fusion ex vivo.

    abstract::Numerous studies have demonstrated the importance of dura mater in the normal development and regeneration of the cranium and its sutures. The purpose of this study was to analyze the effect of dura mater on the metabolism of bone during the process of premature suture fusion. Previously, coronal sutures of fetal rats...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199710000-00003

    authors: Winograd JM,Im MJ,Vander Kolk CA

    更新日期:1997-10-01 00:00:00

  • BMP-4 response in wild-type and craniosynostotic rabbit bone cells.

    abstract:BACKGROUND:Craniosynostosis results from improper regulation of bone formation. Investigations of cells derived from patients with craniosynostosis suggest that craniosynostotic bone-derived cells have increased osteogenic or proliferative capacities compared with other cells. Research into the pathogenesis of craniosy...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181d62ad4

    authors: Cooper GM,Lensie EL,Cray JJ Jr,DeCesare GE,Smalley MA,Losee JE,Mooney MP

    更新日期:2010-05-01 00:00:00

  • A clinical trial in facial fat grafting: filtered and washed versus centrifuged fat.

    abstract:BACKGROUND:Although the increasing trend is to rebuild facial soft-tissue volume with autologous fat transfer, there is no agreement concerning the best way of processing the harvested fat before reinjecting it. Among all the reported fat graft processing techniques, in the present study, the authors compared the clini...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182131d5d

    authors: Botti G,Pascali M,Botti C,Bodog F,Cervelli V

    更新日期:2011-06-01 00:00:00

  • The Addition of Platelet-Rich Plasma to Facial Lipofilling: A Double-Blind, Placebo-Controlled, Randomized Trial.

    abstract:BACKGROUND:Lipofilling is a treatment modality to restore tissue volume, but it may also rejuvenate the aging skin. Platelet-rich plasma has been reported to augment the efficacy of lipofilling, both on graft take and rejuvenation, by altering the adipose-derived stem cells. The authors hypothesized that addition of pl...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PRS.0000000000004081

    authors: Willemsen JCN,Van Dongen J,Spiekman M,Vermeulen KM,Harmsen MC,van der Lei B,Stevens HPJ

    更新日期:2018-02-01 00:00:00

  • Prospective Evaluation of Obese Patients Undergoing Autologous Abdominal Free Flap Breast Reconstruction.

    abstract:BACKGROUND:Obesity has been viewed as a relative contraindication against autologous free flap breast reconstruction because of increased risks of complications, including flap loss. METHODS:The authors conducted a prospective analysis of obese patients undergoing autologous breast reconstruction. RESULTS:Overall, 72...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/PRS.0000000000004550

    authors: Chang EI,Liu J

    更新日期:2018-08-01 00:00:00

  • Classifying deformities of the columella base in rhinoplasty.

    abstract:BACKGROUND:Although much has been published with regard to the columella assessed on the frontal and lateral views, a paucity of literature exists regarding the basal view of the columella. The objective of this study was to evaluate the spectrum of columella deformities and devise a working classification system based...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000022

    authors: Lee MR,Tabbal G,Kurkjian TJ,Roostaeian J,Rohrich RJ

    更新日期:2014-04-01 00:00:00

  • Management of postneurosurgical bone flap loss caused by infection.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should: 1. Be able to define indications and timing for secondary cranioplasty. 2. Understand the surgical options for reconstructing the cranium and overlying soft-tissue defect including their advantages and disadvantages. 3. Be able to apply this knowl...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e3181858eee

    authors: Baumeister S,Peek A,Friedman A,Levin LS,Marcus JR

    更新日期:2008-12-01 00:00:00

  • The impact of chemotherapy and radiation therapy on the remodeling of acellular dermal matrices in staged, prosthetic breast reconstruction.

    abstract:BACKGROUND:An acellular dermal matrix will typically incorporate, in time, with the overlying mastectomy skin flap. This remodeling process may be adversely impacted in patients who require chemotherapy and radiation, which influence neovascularization and cellular proliferation. METHODS:Multiple biopsy specimens were...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000807

    authors: Myckatyn TM,Cavallo JA,Sharma K,Gangopadhyay N,Dudas JR,Roma AA,Baalman S,Tenenbaum MM,Matthews BD,Deeken CR

    更新日期:2015-01-01 00:00:00

  • Epithelioid sarcoma of the upper extremity.

    abstract::Three cases of epithelioid sarcoma of the upper extremity are presented. Information regarding 112 previously published cases is reviewed. It is concluded that epithelioid sarcoma must be included in the differential diagnosis of soft-tissue tumors of the extremities. Moreover, the diagnosis of epithelioid sarcoma dem...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198506000-00008

    authors: Hoopes JE,Graham WP 3rd,Shack RB

    更新日期:1985-06-01 00:00:00

  • Speech outcome and maxillary growth in patients with unilateral complete cleft lip/palate operated on at 6 versus 12 months of age.

    abstract::A prospective study of speech outcome and maxillofacial growth was carried out in cleft palate patients. Seventy-six cleft palate patients were randomly selected for the study group; 41 patients were operated on at 12 months of age, and 35 patients were operated on at 6 months of age. All patients were followed until ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199809030-00009

    authors: Ysunza A,Pamplona MC,Mendoza M,García-Velasco M,Aguilar MP,Guerrero ME

    更新日期:1998-09-01 00:00:00

  • Use of a silicone bag-gel prosthesis to fill in a supratarsal depression of the upper eyelid.

    abstract::A technique is presented for correction of supratarsal depression in the upper lids of orientals, using silicone bag-gel prostheses. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-197812000-00005

    authors: Mutou Y

    更新日期:1978-12-01 00:00:00

  • Short-scar face lift with extended SMAS platysma dissection and lifting and limited skin undermining.

    abstract::In the past 8 years, short-scar cervicofacial rhytidectomy has been used with great success and a high level of patient satisfaction. The operation involves limited incisions in the sideburn and preauricular areas, extending just around the fold of the ear lobule. Extensive undermining of the superficial musculoaponeu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000070945.35807.CE

    authors: Massiha H

    更新日期:2003-08-01 00:00:00

  • Uncircumcision: a historical review of preputial restoration.

    abstract::Throughout history, demands for restoration of the prepuce after circumcision were most commonly related to the political or religious persecution of the Jewish people. The first evidence for such a procedure is mentioned in the Bible: Under the reign of Antiochus IV (168 BC) Hellenistic ideals, such as public nakedne...

    journal_title:Plastic and reconstructive surgery

    pub_type: 历史文章,杂志文章

    doi:10.1097/00006534-199806000-00037

    authors: Schultheiss D,Truss MC,Stief CG,Jonas U

    更新日期:1998-06-01 00:00:00

  • A comparison of obsidian and surgical steel scalpel wound healing in rats.

    abstract::There are several anecdotal clinical articles claiming wound healing and scar superiority using obsidian (volcanic glass) scalpels. In order to determine if skin incisions made with obsidian were superior to those made with standard surgical steel, wound tensile strength, scar width, and histology were assessed in 40 ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Disa JJ,Vossoughi J,Goldberg NH

    更新日期:1993-10-01 00:00:00

  • Stability of biodegradable implants in treatment of mandibular fractures.

    abstract:BACKGROUND:Biodegradable implants have not been used on a large scale for internal fixation of mandibular fractures because of presumed inferior mechanical properties. This prospective clinical trial was designed to elucidate the stability and biocompatibility of self-reinforced poly-L/D-lactide plates and screws used ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000165075.51898.6f

    authors: Yerit KC,Hainich S,Turhani D,Klug C,Wittwer G,Ockher M,Ploder O,Undt G,Baumann A,Ewers R

    更新日期:2005-06-01 00:00:00

  • MOC-PS(SM) CME article: breast augmentation.

    abstract:LEARNING OBJECTIVES:After studying this article, the participant should be able to: 1. Evaluate patients seeking breast augmentation using key variables to assist in selection from the choices for incision, implant type and size, and plane of dissection. 2. Minimize the need for revisionary surgery to factors beyond th...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000305933.31540.5d

    authors: Alpert BS,Lalonde DH

    更新日期:2008-04-01 00:00:00

  • Sensate thoracodorsal artery perforator flap: a focus on its preoperative design and harvesting technique.

    abstract:BACKGROUND:Free sensate thoracodorsal artery perforator flaps that include the posterior divisions of the lateral cutaneous branches of the intercostal nerves have been described. The authors used preoperative color Doppler sonography to identify the nerves and demonstrate its clinical value. METHODS:Fourteen free sen...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181909c34

    authors: Lin CT,Yang KC,Hsu KC,Liu WC,Chen JS,Chen LW

    更新日期:2009-01-01 00:00:00

  • Advanced technologies in plastic surgery: how new innovations can improve our training and practice.

    abstract::Over the last two decades, virtual reality, haptics, simulators, robotics, and other "advanced technologies" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering, and popular literature. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/01.prs.0000138242.60324.1d

    authors: Grunwald T,Krummel T,Sherman R

    更新日期:2004-11-01 00:00:00

  • Labial incompetence: a marker for progressive bone resorption in silastic chin augmentation.

    abstract::Bone erosion below silicone rubber implants is a wellknown sequela, occurring in a majority of patients undergoing augmentation genioplasty. It is generally considered to be self-limiting and with minimal adverse consequences. However, if bone erosion progresses to the extent to which teeth are jeopardized or alterati...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199611000-00012

    authors: Matarasso A,Elias AC,Elias RL

    更新日期:1996-11-01 00:00:00

  • Reconstruction of Philtrum Using Partial Splitting and Folding of Orbicularis Oris Muscle in Secondary Unilateral Cleft Lip.

    abstract:BACKGROUND:The reconstruction of the philtrum during unilateral cleft lip repair remains a surgical challenge. The authors introduce a modified surgical technique for the reconstruction of the philtrum that allows for both the deepening of the philtral dimple and augmentation of the philtral ridge. METHODS:Between Jan...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001795

    authors: Li L,Xie F,Ma T,Zhang Z

    更新日期:2015-12-01 00:00:00

  • The effect of chemosurgical peels and dermabrasion on dermal elastic tissue.

    abstract::Chemosurgical peel is a technique that has been used widely by plastic surgeons and dermatologists to remove fine and deep wrinkles of the skin. However, the reaction of elastic tissue to the cutaneous application of commonly used chemical peeling agents has not been defined. This study comparatively assessed the alte...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199708000-00035

    authors: Giese SY,McKinney P,Roth SI,Zukowski M

    更新日期:1997-08-01 00:00:00

  • A modification of the great-toe transfer for thumb reconstruction.

    abstract::A modification of the great-toe-to-thumb transfer is presented, which includes sculpting the transferred toe with removal of soft-tissue pulp and bone from the lateral side of the toe. This modification provides the aesthetic advantages of the wrap-around flap while avoiding problems of bone graft resorption, pulp mob...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198809000-00033

    authors: Upton J,Mutimer K

    更新日期:1988-09-01 00:00:00

  • Aesthetic outcome of different techniques of reconstruction following nipple-areola-preserving envelope mastectomy with immediate reconstruction.

    abstract:BACKGROUND:Nipple-preserving mastectomy and immediate reconstruction has further improved the aesthetic outcome of skin-sparing mastectomy. To investigate the effect of the type of reconstruction technique on aesthetic outcome, three different methods of reconstruction were compared using four evaluation modalities. M...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000251999.52374.09

    authors: Mosahebi A,Ramakrishnan V,Gittos M,Collier J

    更新日期:2007-03-01 00:00:00