Distraction as a simple and effective method to reduce pain during local anaesthesia; a randomized controlled trial

Abstract Background The administration of local anaesthetics is considered the most unpleasant part of office-based surgery. Many procedural and pharmacological strategies have been developed to minimize pain. In children and adolescents, distraction has been demonstrated to be an effective way of minimizing pain during local anaesthesia. We present a randomized controlled trial of the effect of distraction on pain during local anaesthesia in adults. Material and Methods We have included 115 patients undergoing small office-based surgery to either the face, wrist or arm. We randomized these patients between two groups: a control group and an intervention group. The intervention group watched a distractive video during the administration of the local anaesthetic, for the rest the surgical procedures were performed in an equal fashion in both groups. Preoperative anxiety was scored on a score from 0 to 10 and pain experienced during the injection of local anaesthetic was measured on the visual analogue scale of pain (VAS), ranging from 0 to 10. Patient satisfaction was measured on the Patient Satisfaction Questionnaire (PSQ-18), ranging from 18 to 90. Results Patients had an equal anticipated pain score in control and intervention group. In the intervention group a reduction of pain scores of 1 point was observed (p=0.01). There was no difference in patient satisfaction scores between both groups. Discussion In this study we demonstrate the pain minimizing effect of distraction during the administration of local anaesthesia. Less experienced pain did not result in improved patient satisfaction in our study. We encourage physicians to seek ways to actively distract patients during unpleasant procedures.