anesthetic use for biopsy tracer injection

I was feeling good about things until I read this article , "Relieving the Pain of Sentinel Lymph Node Biopsy Tracer Injection", Clinical Journal of Oncology Nursing, Aug. 2008, Vol. 12, Number 4.  This article talks about the use of eutectic mixture of local anesthetics (EMLA) cream.  In the "At a Glance" section, it says that intradermal injections of radioisotopes are extremely painful; the EMLA is effective and reducing injection pain prior to sentinel node biopsy; and that nurses should advocate for intervention that minimize discomfort during diagnostic procedures.  

I sure hope these nurses have been heard LOUD and CLEAR!  Please tell me they don't just inject this without lidocaine or something to take the edge off the pain.

I'd been looking for articles using the EBSCO host access through the State of Iowa library system.  I want to be an educated health care consumer but now an almost afraid that my natural investigative tendency has brought me more information than I want a week before surgery. - Kay

[dblwhammy]

I had SNB with bilateral mastectomies and isotope injections about 3 hours before the surgery. While not "fun" I would not rate the injections on a pain scale of 1-10 to be more than 3-4. What did surprise me was that there were 4 injections per breast, 1 each in the 4 quadrants around the nipples. Apparently there are different ways to do this procedure. One approach is to inject near the tumor (don't know how many injections there, the other is the circle of 4 injections around the nipple. The doctors told me that the two inner quadrants were a little more painful (I rated 4) than the two outer quadrants (I rated 3) and this was pretty accurate. The pain is not long lasting, less than a minute when the injections are finished. I think I do remember a numbing cream being applied a minute or so before the injections began. Not to bad overall.