Does Pre-injection Local Anesthesia Affect Experienced Pain During Intra-articular Hip Injections.

Pain Scores Following Intrarticular Injections

Intra-articular hip injections are commonly used for diagnostic and therapeutic purposes but are often associated with patient anxiety and fear. The disparity between anticipated and experienced pain during these injections, as well as the role of pre-injection local anesthesia in pain modulation, remains unclear.

This study investigates the difference between anticipated and experienced pain during intra-articular hip injections. In addition, the study examines the impact of pre-injection local anesthesia in 60 prospectively recruited patients, some of whom received pre-injection local anesthesia while others did not. These study findings provide valuable insights into experienced pain during intra-articular hip injections, which can be applied to improve patient experiences and treatment compliance.

Study Overview

• Status: Completed
• Conditions: Pain; Injection; Prevention; Assessment
• Intervention / Treatment: Procedure: Intra-articular corticosteroid injection

Detailed Description

1. Identification of patients in the outpatient clinic and completion of the questionnaires will be carried out by the principal investigator and sub-investigators in the clinic.
2. Data processing will be conducted by physicians holding an MD certification.
3. The type of study is prospective.
4. Data collection will be performed using the medical records of Tel Aviv Medical Center Hospital only, covering the years 2021 and 2022.
5. Demographic data will be collected, including gender, year of birth, age, diagnosis, indication for injection, and previous treatments. Clinical data will include underlying diseases, side of injection, complications, indications, and follow-up time.

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• Israel
  • Tel Aviv, Israel
    • Tel Aviv Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing first-time intra-articular hip injection as indicated by an orthopedic surgeon either for diagnostic (e.g. lidocaine test, arthrography) and/or therapeutic (steroid injection for osteoarthritis) purposes.

Description

Inclusion Criteria:

• Patients undergoing a first-time intra-articular hip injection as indicated by an orthopedic surgeon.
• Indications for injection include:
• Diagnostic purposes (e.g., lidocaine test, arthrography)
• Therapeutic purposes (e.g., steroid injection for osteoarthritis)
• Participants must be 18 years of age or older.
• No previous hip joint injections.
• Ability to fill in the survey questionnaire.

Exclusion Criteria:

• Patients under 18 years of age.
• Patients with a known history of hypersensitivity or allergy to the injectant material (e.g., local anesthetics, steroids).
• Patients lacking the ability to sign informed consent or complete a survey questionnaire.
• Patients with previous hip joint injections, due to the potential for recalling prior pain experienced.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Pre-injection superficial local anesthesia prior to Intra-articular corticosteroid injection	Procedure: Intra-articular corticosteroid injection; Intra-articular hip injections with and without local anastesia and questionnaire about pain and anxiety related to the procedure was administered before and after the injection to the study and control groups.; Other Names: Local anasthesia
Patients without pre-injection local anesthesia prior to Intra-articular corticosteroid injection	Procedure: Intra-articular corticosteroid injection; Intra-articular hip injections with and without local anastesia and questionnaire about pain and anxiety related to the procedure was administered before and after the injection to the study and control groups.; Other Names: Local anasthesia

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numeric rating scales (NRS) scores	Numeric rating scales (NRS) scores were measured before and after an injection in both, study and control groups to determine the anticipated pain compared to experienced pain after Intra-articular hip injection with or without local anasthesia.	Questionnaire was given before the injection for anticipated pain evaluation and additional influencing factors on pain perception prior to injection and right after the injection for actual experienced pain.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Beck Anxiety Inventory (BAI) and fear of injections	Correlation of BAI scores and other injection-related factors including fear of pain, needle visualization, needle size, and prior injection experiences to pre-injection anticipated pain.	Questionnaire was given before the injection for anticipated pain evaluation,Beck Anxiety Inventory (BAI) and additional influencing factors on pain perception prior to injection.

Collaborators and Investigators

• Sponsor: Tel-Aviv Sourasky Medical Center
• Investigators: Study Director: Ehud Rath, Professor, Tel Aviv Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): January 3, 2021
• Primary Completion (Actual): January 2, 2022
• Study Completion (Actual): January 2, 2022

Study Registration Dates

• First Submitted: December 31, 2024
• First Submitted That Met QC Criteria: December 31, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 19, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Keywords: pain; compliance; expectation; injection; intra-articular
• Additional Relevant MeSH Terms: Neurologic Manifestations; Pain
• Other Study ID Numbers: TLV-0674-21

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Due to medical confidentiality

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No