Local Anaesthetic Pain Reduction Techniques

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See strazar et al for a good summary of minimising the pain of local anaesthesia injection.[1]

Solution Preparation

Equipment Factors

  • Use fresh needles with repeated injections
  • Use a small diameter needle

Patient Preparation

  • Distraction
  • Patient looks away

Reducing Needle Puncture Pain

  • Topical anaesthetic creams
  • Cooling with ice
  • Tactile distraction
  • Inject into subcutaneous fat if there is an open wound
  • Insert needle perpendicularly to the skin

Reducing Injection Pain

  • Stabilise the syringe holding hand to reduce needle movement
  • Inject subdermally instead of intradermally
  • Inject a small bleb and then pause
  • Inject very slowly
  • Keep the local anaesthetic wheal 10mm ahead of the needle tip
  • Reinsert the needle only within 1cm of the blanched skin border
  • Learn by asking all patient to score their injeciton pain


  1. โ†‘ Strazar et al.. Minimizing the pain of local anesthesia injection. Plastic and reconstructive surgery 2013. 132:675-684. PMID: 23985640. DOI.