{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:35:00Z","timestamp":1791513300213,"version":"4.3.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Local anesthetic injections can be painful and distressing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to determine whether nitrous oxide, ice, vibration, or topical anesthetic improves analgesia for local anesthetic injections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A cohort study of 400 patients undergoing Mohs micrographic surgery with local anesthetic was conducted. Patients received no intervention ( n = 200), ice ( n = 50), topical anesthetic cream ( n = 50), vibration device ( n = 50), or nitrous oxide ( n = 50). Pain was rated using the Visual Analogue Scale (VAS) and Wong-Baker FACES Pain Rating Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Without intervention, mean VAS was 4.2 and FACES was 4.6. Nitrous oxide was the most successful in reducing pain (mean VAS 1.6 vs. 4.2, P &lt; .01, FACES 1.2 vs. 4.6, P &lt; .01). Topical ice reduced pain (mean VAS 3.0 vs. 4.2, P &lt; .01, FACES 3.0 vs. 4.6, P &lt; .01). Vibration reduced pain (mean VAS 3.5 vs. 4.2, P &lt; .01, FACES 3.6 vs. 4.6, P &lt; .01). Higher pain scores were associated with age &lt;50 ( P = .02), male sex ( P = .05), and surgery on the nose, lip, ear, or eyelid ( P = .02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nitrous oxide, ice, and vibration reduce injection pain. These interventions are especially useful for younger males undergoing surgery on the nose, lip, ear, or eyelid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1203475419867606","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T05:32:55Z","timestamp":1565587975000},"page":"602-607","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2674-9987","authenticated-orcid":false,"given":"Matthew J.","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle P.","family":"Dubin","sequence":"additional","affiliation":[{"name":"Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Khorasani","sequence":"additional","affiliation":[{"name":"Division of Dermatologic Surgery, Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,8,12]]},"reference":[{"key":"bibr1-1203475419867606","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000068822.10113.9E"},{"key":"bibr2-1203475419867606","unstructured":"ASDS Survey on Dermatologic Procedures [Internet]. 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