Lidocaine as a diluent for ceftriaxone in the treatment of gonorrhea. Does it reduce the pain of the injection?
A. Schichor, B. Bernstein, H. Weinerman, J. Fitzgerald, E. Yordan and N. Schechter
Department of Pediatrics, Saint Francis Hospital, Hartford, Conn.
OBJECTIVE: To compare the pain associated with ceftriaxone sodium
injections by using two different diluents, ie, lidocaine hydrochloride and
sterile water. DESIGN: Prospective study of adolescents who were culture
positive for gonorrhea. Random selection of the diluent used for the
intramuscular ceftriaxone therapy. SETTING: Urban, hospital-based
adolescent medicine service. SUBJECTS: Thirty-nine adolescents and young
adults, predominantly of black or Hispanic backgrounds, ranging in age
between 14 and 23 years (mean age, 17.6 years; median age, 17 years), of
whom 27 were females. METHODS: Pain predictions were elicited from the
adolescents before treatment. Pain ratings were obtained at five time
intervals after the injections. All ratings were obtained by using a visual
analog scale. RESULTS: No pain prediction differences before the injection
were noted between the two groups. Individual t tests showed significant
pain differences between the two groups at the time after the injection and
at 10- and 20-minute and 6-hour intervals. Repeated-measures analysis of
variance models showed that the diluent effect on pain was significant.
CONCLUSION: Lidocaine can reduce the amount of pain of an intramuscular
injection of ceftriaxone when compared with sterile water as a diluent.
These findings have implications not only for the treatment of gonorrhea
but also for other situations where intramuscular injections utilizing a
diluent may be necessary.
