Inclusion and exclusion criteria
allergic, anxiety, skin pain, impaired or unstable coagulation, infection
INFECTION
The patient inclusion criteria were 1) age ≥ 16 years Asian, 2) undergoing orthopedic surgery distal to the elbow, 3) American Society of Anesthesiologists (ASA) I–II physical status, 4) hospitalized patients who receiving intradermal injection of local anesthesia (intradermal lidocaine injection) prior to the ultrasound-guided axillary approach to brachial plexus block. The exclusion criteria were 1) emergency surgery, 2) analgesic medication within 6 h prior to injection, 3) anxiolytics or antidepressants medication status, impaired or unstable coagulation situation, 4) infection, 5) pre-existing skin pain at the site of needle insertion or of the involved limb, 6) allergic to local anesthesia, and 7) poor cooperation or verbal communication. Before the injection procedures, all patients were instructed to rate needle injection anxiety scores using a 5-point Likert scale [