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document
Administration of subcutaneous buffered lidocaine prior to breast lymphoscintigraphy reduces pain without decreasing lymph node visualization . UNLABELLED Breast lymphoscintigraphy using ( 99m ) Tc-sulfur colloid ( ( 99m ) Tc-SC ) is well established in clinical practice for staging patients with breast carcinoma . Nearly all patients report having pain during the procedure . However , techniques used to minimize pain during breast lymphoscintigraphy are highly variable across institutions . Our study was to determine whether anesthetizing the skin with sodium bicarbonatehether-buffered lidocaine before performing breast lymphoscintigraphy reduced the pain experienced by the patients . The second objective of this study was to evaluate whether anesthetizing the skin with buffered lidocaine changed visualization of lymph nodes . METHODS This prospective , patient-masked and randomized study involved performing breast lymphoscintigraphy in a control group and experimental group of female breast cancer patients . The control group did not receive skin anesthetic before ( 99m ) Tc-SC injections , whereas the experimental group first underwent skin anesthesia with an injection of 2 % sodium bicarbonate-buffered lidocaine . All patients were asked to rate their pain levels , using the National Institutes of Health pain scale , before the procedure and immediately after the injections . The change in pain from baseline was compared between the 2 groups . After the injections , scintigraphic imaging of the axilla was performed , and the number of axillary lymph nodes visualized was recorded . RESULTS No significant difference was found in preprocedural baseline pain from the control group , compared with the experimental group . There was a statistically significant difference in the increase in pain experienced during the procedure between the control group and the experimental group ( P = 0.009 ) . There was no significant difference in the detection of lymph nodes between the control and experimental groups ( P = 0.56 ) . CONCLUSION The results from our study indicate that injecting subcutaneous buffered lidocaine before intradermal injection of ( 99m ) Tc-SC for breast lymphoscintigraphy significantly decreases patient pain without interfering with lymph node visualization .
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Intervention_Pharmacological
lidocaine
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Intervention_Physical
lymphoscintigraphy
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Intervention_Pharmacological
sodium bicarbonatehether-buffered lidocaine
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Intervention_Physical
breast lymphoscintigraphy
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Intervention_Pharmacological
2 % sodium bicarbonate-buffered lidocaine
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Intervention_Pharmacological
lidocaine
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Outcome_Pain
pain
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Outcome_Pain
pain
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Outcome_Pain
pain
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Outcome_Pain
pain
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Outcome_Physical
visualization of lymph nodes .
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Outcome_Pain
rate their pain levels , using the National Institutes of Health pain scale
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Outcome_Pain
change in pain from baseline
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Outcome_Physical
number of axillary lymph nodes visualized
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Outcome_Pain
baseline pain
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Outcome_Pain
increase in pain
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Outcome_Physical
detection of lymph nodes
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Outcome_Pain
patient pain
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Outcome_Physical
lymph node visualization .
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Participant_Condition
breast lymphoscintigraphy
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Participant_Condition
breast carcinoma
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Participant_Condition
breast lymphoscintigraphy
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Participant_Condition
breast lymphoscintigraphy
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Participant_Sex
female
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Participant_Condition
breast cancer