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Participants will have local anesthesia administered to the palmar aspect of both forearms using 4 different injection methods in order to determine which method provides the best results in terms of perceived pain, overall comfort, and participant preference. Injection site cooling and solution buffering using a 3:1 ratio will be compared to the current standard, no injection site cooling and 9:1 solution buffering.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Left Forearm Injection Sites Cooled, Right Forearm Injection Sites at Room Temperature | Experimental | Palmar aspect of participants left forearm will have a cold compress pack placed on it. The palmar aspect of the right forearm will have a room temperature compress pack placed on it. Each forearm will be injected with 1mL of lidocaine with epinephrine buffered with sodium bicarbonate. Each forearm will be injected once with the experimental ratio (3:1) and once with the standard control ratio (9:1). Injections will be administered in a randomized order. |
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| Right Forearm Injection Sites Cooled, Left Forearm Injection Sites at Room Temperature | Experimental | Palmar aspect of participants right forearm will have a cold compress pack placed on it. The palmar aspect of the left forearm will have a room temperature compress pack placed on it. Each forearm will be injected with 1mL of lidocaine with epinephrine buffered with sodium bicarbonate. Each forearm will be injected once with the experimental ratio (3:1) and once with the standard control ratio (9:1). Injections will be administered in a randomized order. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cold Compress Pack | Other | Palmar aspect of forearm will have a cold compress pack placed on it. |
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| Measure | Description | Time Frame |
|---|---|---|
| Pain from Needle Insertion | Pain from needle insertion during each injection will be scored on a 0 - 10 scale by participants | 2 Months |
| Pain from Solution Deposition | Pain from solution deposition during each injection will be scored on a 0 - 10 scale by participants | 2 Months |
| Overall Comfort Level During Injection | Comfort level during each injection will be scored on a 0 - 10 scale by participants | 2 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Injection Method Preference | Participants will select which of the 4 injection methods they preferred | 2 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Buffered Anesthetic Solution pH | pH of each solution will be measured using a calibrated pH probe | 2 Months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nicholas Bastidas, MD | Northwell Health | Principal Investigator |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D017693 | Sodium Bicarbonate |
| ID | Term |
|---|---|
| D001639 | Bicarbonates |
| D002254 | Carbonates |
| D002255 | Carbonic Acid |
| D017554 | Carbon Compounds, Inorganic |
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Palmar aspect of participants forearms will be randomized to have either a cold compress pack or a room temperature compress pack placed on it. The cold compress pack serves as the trial intervention and the room temperature compress pack serves as the placebo. Each forearm will then be injected with both a 3:1 (experimental ratio) and a 9:1 (standard ratio) mixture of lidocaine with epinephrine:sodium bicarbonate in a randomized order.
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Participants will be blind to the solution ratio of each injection, injector will not be blind to solution to ensure safety.
| Room Temperature Compress Pack | Other | Palmar aspect of forearm will have a room temperature compress pack placed on it. |
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| Lidocaine Epinephrine | Drug | Lidocaine with epinephrine will be buffered 3:1 with sodium bicarbonate |
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| Lidocaine Epinephrine | Drug | Lidocaine with epinephrine will be buffered 9:1 with sodium bicarbonate |
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| D007287 |
| Inorganic Chemicals |
| D017670 | Sodium Compounds |