A colleague, several years ago, in discussing local anesthesia for tonsillectomy, expressed the belief that adequate anesthesia depended more upon the degree of distention obtained in the peritonsillar tissues than upon the strength of the anesthetic solution.
This suggested that perhaps simple distention of the skin with an innocuous fluid might provide sufficient anesthesia for minor dermatological surgical procedures. Sterile distilled water was tried, and, although local anesthesia was produced, the initial stinging sensation was sufficiently pronounced to discourage its routine use. During the past two years sterile isotonic saline solution has been used with satisfactory results, the injection being practically painless.
The injection technique is simple. The saline solution is introduced intradermally. A 26-gauge needle is inserted bevel side up, and the injection is made as superficially as possible so as to produce elevation and pallor both around and beneath the lesion. Usually 1
SHELTON JM. Distention Anesthesia for Minor Dermatological Procedures. AMA Arch Derm. 1957;75(1):130. doi:10.1001/archderm.1957.01550130132019
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