LIDOCAINE AS A DILUENT FOR CEFTRIAXONE IN THE TREATMENT OF GONORRHEA - DOES IT REDUCE THE PAIN OF THE INJECTION

Objective: To compare the pain associated with ceftriaxone sodium inje ctions by using two different diluents, ie, lidocaine hydrochloride an d sterile water.Design: Prospective study of adolescents who were cult ure positive for gonorrhea. Random selection of the diluent used for t he intramuscular ceftriaxone therapy. Setting: Urban, hospital-based a dolescent medicine service. Subjects Thirty-nine adolescents and young adults, predominantly of black or Hispanic backgrounds, ranging in ag e between 14 and 23 years (mean age, 17.6 years; median age, 17 years) , of whom 27 were females. Methods: Pain predictions were elicited fro m the adolescents before treatment. Pain ratings were obtained at five time intervals after the injections. All ratings were obtained by usi ng a visual analog scale. Results: No pain prediction differences befo re the injection were noted between the two groups. Individual t tests showed significant pain differences between the two groups at the tim e after the injection and at 10- and 20-minute and 6-hour intervals. R epeated-measures analysis of variance models showed that the diluent e ffect on pain was significant. Conclusion: Lidocaine can reduce the am ount of pain of an intramuscular injection of ceftriaxone when compare d with sterile water as a diluent. These findings have implications no t only for the treatment of gonorrhea but also for other situations wh ere intramuscular injections utilizing a diluent may be necessary.