The use of a vibrating kinetic anesthesia device (KAD) may be well-tolerated and effective in reducing pain associated with infiltrative lidocaine injections for biopsy and excisional surgery, according to the results of an open-label randomized controlled trial published in the Journal of the American Academy of Dermatology.
Healthy adults who could tolerate lidocaine injections were randomly assigned to receive lidocaine injections in the lateral forehead (n=14), lateral back (n=14), and nasofacial sulcus (n=19) with or without KAD. Room temperature 1% lidocaine was buffered with 8.4% sodium bicarbonate and the KAD was used on the skin adjacent to the injection site for the entire duration of the injection. A 100-mm visual analog scale (VAS) was used to rate the pain associated with the injection. Investigators also queried participants on injection preference and interference of KAD.
The use of KAD was associated with a lower patient-reported VAS score compared with unassisted injections (7.5 mm; interquartile range IQR] 5mm-16mm] vs 26 mm; IQR 13 mm-34 mm, respectively). Participants receiving injections with KAD had a mean pain decrease of 15 mm (95% CI, 9.8 mm-20.1 mm; P <.0001 for reduction in pain score; P =.0295 for pain score reduction >10 mm).
A higher percentage of participants preferred injections with vs without KAD (73.3% vs 13.3%, respectively), and 13.3% of patients reported no preference between the 2 methods. In addition, a lower percentage of patients reported that the KAD bothered them during the procedure compared with patients who reported no bothersome interactions with KAD (22.2% vs 77.8%, respectively).
Limitations of the study include a small sample size, the inclusion of only healthy volunteers, and the lack of blinding to intervention.
“The strong patient preference and low side effect profile for this analgesic technique merit consideration for its inclusion in daily practice,” the researchers wrote.
Fix WC, Chiesa-Fuxench ZC, Shin T, et al. Use of a vibrating kinetic anesthesia device (KAD) reduces the pain of lidocaine injections: a randomized split-body trial [published online August 18, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.08.011