Judging Pain Sensitivity with Subcutaneous Lidocaine Injections

Abstract

This study shows normal distribution of verbal pain response to a clinical pain stimulus in a clinical population. Body movement and anxiety correlated with verbal pain intensity ratings. Subcutaneous injections of lidocaine may be a useful model for exploration of pain sensitivity in a clinical population.

Does Pain Score in Response to a Standardized Subcutaneous Local Anesthetic Injection Predict Epidural Steroid Injection Outcomes in Patients with Lumbosacral Radiculopathy? A Prospective Correlational Study

“…In a study by Manabat et al. that evaluated the use of subcutaneous lidocaine injections to estimate pain sensitivity before interventional procedures, the authors found a positive association between subcutaneous pain scores and baseline anxiety. However, most of these patients underwent injections overlying their primary pain location.…”

“…Second, performing the LA infil-tration at a distinct location remote from the patient's primary radicular pain could minimize the affective response to painful peripheral stimulation, and negate the effects of peripheral sensitization. In a study by Manabat et al [37] that evaluated the use of subcutaneous lidocaine injections to estimate pain sensitivity before interventional procedures, the authors found a positive association between subcutaneous pain scores and baseline anxiety. However, most of these patients underwent injec- Despite efforts devoted to developing clinical tools for the objective assessment of pain, pain assessment remains largely subjective and unpredictable.…”

Understanding and Minimising Injection-Site Pain Following Subcutaneous Administration of Biologics: A Narrative Review

“…Attempts to minimise patient movement and muscle stiffness, which are often associated with higher anxiety levels, during the SC injection process may help to lessen any ISP given that body movement and anxiety have correlated with verbal pain intensity ratings [87]. The development of a 'ritualised' routine for when, where and how to inject can help patients' control of the process, improve confidence and reduce injection-associated anxiety [88].…”

Validation of the English Language Pain Sensitivity Questionnaire

“…[22][23][24][25][26] The sensations evoked by a subcutaneous lidocaine stimulus have sufficient reproducibility to allow for statistical comparison between alternate treatment groups and to demonstrate differences with relatively small numbers of subjects. [27][28][29] Most pertinent to our study, the subcutaneous infiltration of lidocaine has been used as a standardized experimental pain stimulus to assess hyperalgesia 30 and verbal and behavioral pain responses 31 in patients undergoing interventional pain treatment procedures for chronic low back pain. A recent report suggests this may be useful even as a predictor of outcomes.…”