Repetitive pinching of the skin during lidocaine infiltration reduces patient discomfort

Background: The administration of a local anesthetic is often painful. Objective: The purpose of this study was to determine whether rapidly shaking and pinching the skin during local anesthetic administration decreases pain perception. Methods: The skin at the intended site of lidocaine injection was rapidly pinched between the thumb and forefinger just before the injection. Control patients received no intervention. Patients reported their pain perception using a visual analog scale (0 to 10). In the feasibility phase, patients were assigned to receive the pinching technique or no intervention, then randomized in the second phase. Results: In phase 1, 34 patients received 42 excisions. Pain was significantly reduced (p = 0.001) in the treatment group. In phase 2, 69 patients had 91 excisions. When adjusted for age and sex (data combined from phases 1 and 2), the treatment significantly reduced pain (p = 0.03) when compared with no intervention. Conclusion: We describe a simple, noninvasive technique that significantly lowered perceived pain during the administration of unbuffered lidocaine with epinephrine local anesthetic.