What do systematic reviews say?

Multiple vs single‐injection technique

Multiple showed no clear difference in intravascular injection compared with single‐injection technique (moderate certainty).

• Single, double or multiple‐injection techniques for non‐ultrasound guided axillary brachial plexus block in adults… 2016 · Cochrane Headline outcomes only
  RR 1.35 [0.2, 9.06]
  4 studies · 352 participants
  Moderate

Multiple vs double‐injection technique

Multiple showed no clear difference in intravascular injection compared with double‐injection technique (moderate certainty).

• Single, double or multiple‐injection techniques for non‐ultrasound guided axillary brachial plexus block in adults… 2016 · Cochrane Headline outcomes only
  RR 0.69 [0.32, 1.49]
  7 studies · 676 participants
  Moderate

Double vs single‐injection technique

Double showed no clear difference in intravascular injection compared with single‐injection technique (low certainty).

• Single, double or multiple‐injection techniques for non‐ultrasound guided axillary brachial plexus block in adults… 2016 · Cochrane Headline outcomes only
  RR 4.15 [0.46, 37.13]
  2 studies · 90 participants
  Low

Adverse effects of pharmacological intervention vs control

Adverse effects of pharmacological intervention showed no clear difference in pain on injection compared with control (low certainty).

• Pharmacological and non‐pharmacological interventions for reducing rocuronium bromide induced pain on injection in… 2016 · Cochrane Headline outcomes only
  RR 0.47 [0.09, 2.46]
  1 study · 118 participants
  Low

Plain lidocaine vs buffered lidocaine

• Adjusting the pH of lidocaine for reducing pain on injection 2010 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 685 participants
  Moderate

Intervention not reported

• Peripheral nerve blocks for hip fractures in adults 2020 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 75 participants
  Moderate

4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment; 147 participants, 147 interventions (2 studies); unclear whether data relate to just solution deposition. Not pooled/graded.
  2 studies · 147 participants
  GRADE not reported

4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment (orphan study); 86 participants, 172 interventions (1 study). Not pooled/graded.
  1 study · 86 participants
  GRADE not reported
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment (orphan study; exact time of follow-up not reported); 86 participants, 172 interventions (1 study). Not pooled/graded.
  1 study · 86 participants
  GRADE not reported

3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment (orphan study; unclear whether data relate to just solution deposition; SDs not reported); 18 participants, 36 interventions (1 study). Not pooled/graded.
  1 study · 18 participants
  GRADE not reported
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% articaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

0.5% bupivacaine, 1:200,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment (orphan study; unclear whether data relate to just solution deposition; SDs not reported); 18 participants, 36 interventions (1 study). Not pooled/graded.
  1 study · 18 participants
  GRADE not reported

4% articaine, 1:200,000 epinephrine vs 4% articaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

2% mepivacaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found
• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment (orphan study; unclear whether data relate to just solution deposition); 48 participants, 48 interventions (1 study). Not pooled/graded.
  1 study · 48 participants
  GRADE not reported

4% articaine, 1:200,000 epinephrine vs 0.5% bupivacaine, 1:200,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% prilocaine plain vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: See comment; 0 participants (0 studies); 1 case of prolonged anaesthesia recorded; no clinical studies met the outcome definition (unable to confirm whether prolonged anaesthesia = paraesthesia).
  0 studies
  No studies found

3% prilocaine, 0.03 IU felypressin vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

2% mepivacaine, 1:100,000 epinephrine vs 2% lidocaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found

4% articaine, 1:100,000 epinephrine vs 2% mepivacaine, 1:100,000 epinephrine

The review found no eligible studies for this question.

• Injectable local anaesthetic agents for dental anaesthesia 2018 · Cochrane All outcomes
  SoF: Not measured.
  0 studies
  No studies found