Minimizing injection pain in local anesthesia.

The choice of needle diameter can influence the pain felt by the patient. A well-designed randomized controlled trial (RCT) showed an inverse relation between needle diameter and pain. A smaller needle also forces the injector to slow down, minimizing pain from volume expansion. A longer needle (e.g., 1 1/4” v. 5/8”) is useful for injecting larger areas. In addition, warming the solution results in a less painful injection. Buffering lidocaine with sodium bi carbonate can minimize the typical burning sensation