Laser assisted delivery of topical anesthesia for intramuscular needle insertion in adults

Background and Objectives Currently there is no safe, effective, and rapid means to eliminate the pain associated with a needle insertion through the skin. It is hypothesized that ablation of the stratum corneum layer using a low energy Erbium(Er):YAG laser would allow rapid local anesthesia from a lidocaine product. Study Design/Materials and Methods Eighty volunteers participated in a placebo‐controlled, double blind, cross‐over study employing the Norwood–Abbey (Chelsea Heights, Victoria, Australia) laser anesthesia device (LAD) and two lidocaine preparations. Upper‐arm skin ablation was followed by a 5‐minute application of study treatment. Pain scores were registered immediately following a needle insertion. Results Comparing the combined lidocaine preparations to placebo, there was a statistically significant reduction in pain when the LAD was employed ( P < 0.001). The median pain reduction for lidocaine was 51.3% (95% CI = [40.9, 76.1]). Conclusions Use of the low energy Er:YAG LAD device in combination with a 5‐minute application of lidocaine significantly reduced the pain associated with a needle insertion. Lasers Surg. Med. 31:252–256, 2002.