Comparison of injection pain of articaine and lidocaine in eyelid surgery

Purpose: To compare the pain induced by tissue infiltration of lidocaine 2% with epinephrine 1:100,000 versus articaine 4% with epinephrine 1:100,000 for eyelid surgery. Methods: Thirty patients undergoing bilateral eyelid surgery were enrolled in a prospective, randomized, double-masked study. Each subject received injections of lidocaine 2% with epinephrine 1:100,000 (Xylocaine) on one side and articaine 4% with epinephrine 1:100,000 (Septocaine) on the other for surgical anesthesia. The patients rated the pain of infiltration using a 100-mm visual analogue scale immediately after receiving each injection. The pain scores were compared using the paired t test. Results: Twenty-two of the 30 patients (73.3%) rated the articaine injection as less painful than the lidocaine injection. The mean pain score for lidocaine was 42.60 ± 24.74 and the pain score for articaine was 31.85 ± 20.28 (p = 0.011). Conclusions: In this study, infiltration of articaine was less painful than lidocaine for eyelid surgery, making articaine an attractive alternative for local anesthesia.