local anesthesia

 Q:  Local anesthetic is more painful when injected in subcutaneous (SQ) tissue rather in intradermal area?

A) True

B) False

Answer: B

Although this is true that intradermal injection of local anesthetic is more effective but simultaneously it is more painful. Instead direct infiltration of local anesthetic into subcutaneous layers not only provides analgesia effectively but is relatively less painful. Also, to note that diluted local anesthetics near the nerve fibers (in SQ) produces analgesia but has less effect on the sense of touch or temperature.

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References:

1. McCreight, A, Stephan, M. Local and regional anesthesia. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King, C, Henretig, FM (Eds), Lippincott, Williams, & Wilkins, Philadelphia 2008. p.439. 

Tetzlaff JE. The pharmacology of local anesthetics. Anesthesiol Clin North America 2000; 18:217.