Differential Analgesia From Vibratory Stimulation During Local Injection of Anesthetic: A Randomized Clinical Trial

Abstract

BACKGROUND-Inadequate pain reduction during anesthetic injection is a significant medical and surgical problem. Vibratory distraction reduces this pain; however, there are minimal data identifying those who respond best. OBJECTIVE-To quantify analgesia from vibration before anesthetic injection.MATERIALS AND METHODS-In this partially blinded, single-institution trial, adult participants were randomized to intervention (vibratory anesthetic device, VAD ON) or placebo (VAD OFF). Pain was assessed using the 11-point numeric rating scale (NRS). Relative reduction in NRS between VAD OFF and ON was used to identify minimum clinically important and substantially clinically important difference in pain.RESULTS-One hundred one tested sites from 87 subjects were assessed. Sixty-three percent were men with a median age of 66 years. From univariate analysis, males, subjects aged <60, and head and neck (HN) treated subjects had a significant reduction in NRS (p < .05). Multivariate analysis identified NRS reductions in females <60 (p = .012), males ≥70 (p = .002), females and males treated on HN (p = .048 and p = .035, respectively), and males ≥70 treated on HN (p = .012). Substantially clinically important difference (≥57% NRS reduction) included subjects <60, females <70, HN treatment aged 60 to 69, males ≥70, and females treated on HN.CONCLUSION-Vibratory anesthetic device reduces pain during anesthetic injection, primarily for HN treatments and older male subjects.

Use of vibrating anesthetic device reduces the pain of mesotherapy injections: A randomized split‐scalp study

“…Pain due to injections can be reduced by tactile distraction with VAD. 7 Vibration rationale relies on the "gate control" theory of pain proposed by Melzack and Wall, which translates to the decrease of the intensity of pain by concurrent transmission of nonpainful stimuli, such as vibration. 3,5,6,8,11 The authors stated that the transmission of sense of vibration from mechanoreceptors located in the skin via A-β nerve fibers results in the shutting down of a "gate" through which pain signals are transmitted to the brain through A-δ and C fibers.…”

“…3,5,6,8,11 The authors stated that the transmission of sense of vibration from mechanoreceptors located in the skin via A-β nerve fibers results in the shutting down of a "gate" through which pain signals are transmitted to the brain through A-δ and C fibers. 3,7 Pain from injections varies depending on the anatomical site 7 and minimizing patient discomfort remains a top priority for all invasive procedures. Scalp is one of the most challenging sites to reach this goal.…”

“…Approximately 12 million dermatologic procedures are performed annually, including injectables for cosmetic or therapeutic purposes. Vibration has been successfully used in several clinical settings, such as dermatological procedures, pediatrics, and dentistry 7 . Vibration anesthesia during scalp mesotherapy has yet to be studied.…”

“…Vibration has been successfully used in several clinical settings, such as dermatological procedures, pediatrics, and dentistry. 7 Vibration anesthesia during scalp mesotherapy has yet to be studied.…”

Olfactory Sensitivity Is Related to Erectile Function in Adult Males

“…In the retrospective cohort study, all participants underwent a phone call session to answer trial questions ("What is your pain level for your nasal symptoms?") using the 11-point NRS, where 0 is not painful and 10 is the most worse painful (Kazi et al, 2019).…”