Objective: To determine whether reducing the speed of injection is eff
ective in reducing injection pain for buffered and unbuffered lidocain
e solutions. Methods: A prospective, single-blind, randomized, crossov
er, laboratory study was performed. Adult volunteers were recruited fr
om ED staff at an urban teaching hospital to serve as subjects. Twenty
-nine subjects each received 4 1-mL injections into the dorsum of the
hands. Each subject received fast and slow injections of buffered and
unbuffered lidocaine. Subjects rated the pain of each injection on a 1
00-mm visual analog scale (VAS). Mean pain scores for each interventio
n were compared using analysis of variance. Results: The mean pain VAS
score for fast injection of buffered lidocaine was 14.1 mm. For slow
buffered injection, the mean pain score was 11.4 mm (p = 0.98). For un
buffered lidocaine, the means were 28.7 mm for fast injection and 22.2
mm for slow injection (p = 0.40). Conclusions: Reducing injection spe
ed did not produce a statistically significant change in injection pai
n for either buffered or unbuffered solutions.