Topical Lidocaine 2% Gel for Analgesia and Patient Comfort during Interscalene Brachial Plexus and Axillary Blocks: A Noninferiority Randomized Trial

Methods: Thirty subjects undergoing surgery of the upper limb were randomized into three treatment groups. Group 1 received 10 g (10 mL) topical lidocaine 2% gel applied to the skin surface over the brachial plexus, Group 2 received a skin infiltration in the same area with 3 cc lidocaine 2%, and Group 3 received aqueous non-medicated ultrasound gel applied over the interscalene space. These treatments were applied 5 min prior to placement of the nerve block. Primary outcome variables were Visual Analogue Scale (VAS) pain scores during needle insertion and injection. Fearfulness of the nerve block was by verbal report on a 5-point Likert scale.