Comparison of anesthesia due to lidocaine injection or lidocaine push with diphenhydramine injection or diphenhydramine push in head and face wound healing

Abstract

Patients with trauma presenting to the emergency department with facial lacerations often anticipate forthcoming procedures with apprehension, primarily due to needle injection anxiety preceding reparative interventions. This concern is particularly genuine among pediatric patients and many adults. The aim of this study was to compare the efficacy of lidocaine and diphenhydramine via injection and push in reducing pain during suturing. method: This study is an interventional double-blind trial involving conscious trauma patients with Glasgow Coma Scale, GCS=15. After obtaining informed consent, patients were randomized into four groups of 50 individuals (receiving diphenhydramine injection, lidocaine injection, diphenhydramine push, and lidocaine push) using Excel randomization software. Numbered medications and syringes were used, with only the researcher aware of their content. After five minutes from achieving anesthesia, suturing was performed. Pain intensity was assessed by using the Visual Analog Scale (VAS). Results: In this study, 200 patients were included, aged between 18 and 60 years. The mean age of patients was 34.1 ± 12.97 years (95% CI: 32.18 - 35.81), with a median age of 32 years and an interquartile range of 22 to 42 years. Lidocaine injection resulted in higher pain experienced during injection compared to diphenhydramine, although this difference was not significant (p=0.073). However, the pain experienced was significantly higher with diphenhydramine injection and lidocaine injection compared to diphenhydramine push and lidocaine push (p<0.001). the pain during suturing was lower with lidocaine injection compared to diphenhydramine push and lidocaine push, this difference was not significant with diphenhydramine push (p=0.386) but was significant with lidocaine injection (p<0.001).