Oral Presentation New Zealand Association of Plastic Surgeons Annual Scientific Meeting

Are individuals with tattoos less tolerant of local anaesthetic injections than their non-tattooed counterparts? (860)

Louise Thomas 1 , Eric Kim 1 , Rebecca Ayers 1 , Will McMillan 1 , Patrick Lyall 1 , Anne Collins 1
  1. Plastic Surgery Department, Southern DHB, Dunedin, OTAGO, New Zealand

Background

The pain and discomfort associated with local anaesthesia (LA) is associated with a number of variables, including patient characteristics.1 Concurrent needle phobia, which affects 10% of the population, can further intensify anxiety levels in affected individuals.2 Whilst it has previously been suggested that patients with tattoos are less tolerant of phlebotomy than those without, their perception of pain associated with LA has not been reported previously. The aim of this study was to ascertain whether people with tattoos are less tolerant of LA injections than their non-tattooed counterparts. Secondary outcomes included evaluation of the impact of additional patient characteristics on pain perception.

 

Methods

All patients undergoing day case LA procedures were invited to participate. The percentage of total body surface area (TBSA) of tattoos present was calculated using the palm method. The surgeon rated their impression of observed pain a standardised comparative pain scale chart. Patients rated the pain experienced using the same scale. A study-specific scoring system, the WUSS score (Willingness to Undergo the Skin Sting), was also included. This incorporated factors such as the need for handholding and crying. Total pain scores were calculated as a combination of the standardised and WUSS scores.

 

Results

Statistical analysis revealed a significant difference between the total pain scores of patients with tattoos compared to those without. There was a strong positive correlation between %TBSA of tattoos and pain scores. In addition, there was a significant difference between the pain scores of male and female patients.

 

Discussion

The pain scores of patients with tattoos were significantly higher than those without, with higher scores recorded in those with a greater %TBSA of tattoos.

 

Conclusions

Patients with tattoos are less tolerant of LA injections than their non-tattooed counterparts. This study also confirms the superiority of the female sex with regard to pain tolerance.

  1. Kaufman, E., Epstein, J.B., Naveh, E., Gorsky, M., Gross, A. and Cohen, G., 2005. A survey of pain, pressure, and discomfort induced by commonly used oral local anesthesia injections. Anesthesia progress, 52(4), pp.122-127.
  2. Hamilton, J.G., 1995. Needle phobia: a neglected diagnosis. Journal of Family Practice, 41(2), pp.169-182.