Comparison of different delivery methods of lidocaine and diphenhydramine for anesthesia during suturing of head and facial lacerations

Purpose: Head and facial lacerations often require effective anesthesia for proper repair and healing. This study aims to evaluate the effectiveness of lidocaine and diphenhydramine, administered via injection or margin push, in providing appropriate anesthesia for patients’ pain during suturing head and face lacerations. Materials and Methods: This study involved 200 trauma patients with head and face lacerations. All patients had a 15 GCS. Patients were divided into 4 groups of 50. In the first group, lidocaine was injected around the wound, in the second group diphenhydramine was injected around the wound, in the third group lidocaine was pushed through the wound margin, and in the last group, diphenhydramine was pushed. After 5 minutes the pain intensity was evaluated based on the VAS system. Results: Patients had an average age of 34.1 years. Regarding gender distribution, most patients were male (84.5%). The diphenhydramine injection method was the most effective in reducing pain, while the lidocaine push method was the least effective. Regardless of the agent used for anesthesia, the injection method showed better effects than the push method. In the injection methods, the diphenhydramine-injected group experienced lower pain levels than the lidocaine-injected group before and during suturing. Conclusion: Diphenhydramine injection had a superior pain reduction compared to other methods. Considering the lack of substantial difference in the level of anesthesia between lidocaine injection and diphenhydramine injection and diphenhydramine push, diphenhydramine push can be used to prevent pain during the suturing procedure.