The amount of lidocaine provided in most kits is often inadequate. The authors recommend supplementing the kit with a 10-mL syringe and a bottle of 1% lidocaine. Make sure not to exceed the maximal recommend dose of 4.5 mg/kg of lidocaine. A smaller needle (27 gauge, 1.25 in.) may be used for infiltration. Smaller needles are shown to be associated with less pain during local anesthesia.
Local anesthetic agents are used to increase patient comfort during the procedure.
Lidocaine is an amide local anesthetic used in a 1-2% concentration. This agent inhibits depolarization of type C sensory neurons by blocking sodium channels. Epinephrine prolongs the effect and enhances hemostasis (maximum epinephrine dose, 4.5-7 mg/kg).