The effect of local anaesthetic type on injection-related pain levels intra and post operatively

INTERVENTION: A total of 2ml of 3% mepivacaine plain will be injected in the hallux (with 5ml syringe and a .25 gauge, 25mm in length) prior to the partial nail avulsion procedure. The subject will receive 1ml of mepivacaine into the soft tissue on the lateral (1st injection) and medial (2nd injection) aspects of the proximal phalanx. The partial nail avulsion will only be performed once the anaesthetic has taken effect. If anaesthesia has not been achieved then a top up injection will be performed. The allocation of which hallux, right or left that receives lignocaine or mepivacaine will be randomised. Immediately after the injections into the medal and lateral aspects of the toe the subject will complete a visual analogue pain scale, if further injections are required then the visual analogue scale will be completed after the first (lateral aspect) and second injection (medial aspect). Crossover will be achieved by the randomly selected hallux will receive lignocaine or mepivacaine and the opposite hallux will be injected immediately after the subject has completed the visual analogue scale. CONDITION: Partial Nail Avulsion PRIMARY OUTCOME: Pain measured by Visual Analogue Scale SECONDARY OUTCOME: Pain measured by Visual Analogue Scale INCLUSION CRITERIA: Patients eligible for and undergoing bilateral hallux partial nail avultion surgery (in accordance with the University of Newcastle Podiatry criteria) Minimum weight of 70kg Able to safely receive the local anaesthetic agents used (in accordance with the University of Newcastle Podiatry criteria) Over 18 yrs of age Proficient in English to give Informed Consent and follow post‐operative care instructions