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  1. John Joseph Reynolds-Wright1,2
  1. 1Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK
  2. 2NHS Lothian, Chalmers Centre, Edinburgh, UK
  1. Correspondence to Dr John Joseph Reynolds-Wright, Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK; jjrw{at}doctors.org.uk

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Vulvar skin is very sensitive and so an anaesthetic is recommended to minimise pain during biopsy of vulvar lesions. However, local anaesthetic injections themselves can be painful. Clinical guidelines often suggest considering adding a ‘buffer’ to a local anaesthetic to minimise pain on injection, yet the evidence base for this is minimal. This randomised controlled trial (RCT) compared plain lidocaine 1% with lidocaine 1% plus sodium bicarbonate. The trial was powered to show a difference in 15 mm on a 100 mm visual analogue scale; however, no difference between study groups was detected. Topical lidocaine cream or gel may prove more effective as this would remove any injection pain and anxiety related to the use of a needle.

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Footnotes

  • Twitter @doctorjjrw

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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