• Aloka Samantaray and Mangu Hanumantha Rao.
• Department of Anaesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, SVIMS University, Tirupati, Andhra Pradesh, India.
• Indian J Crit Care Med. 2014 Jul 1; 18 (7): 421-6.

ContextCentral venous catheter (CVC) insertion induces pain and discomfort to a conscious patient despite application of a local anesthetic (LA) field block and this pain can be greatly lessened by using additional analgesics.AimThe aim of this study is to evaluate the efficacy of fentanyl along with LA field infiltration in controlling pain and discomfort associated with CVC insertion.Settings And DesignA prospective, randomized, double-blind, placebo-controlled trial was conducted at tertiary referral center.Materials And MethodsFifty-four patients scheduled for planned CVC were randomly assigned to receive either fentanyl (2 μg/kg) or 0.9% normal saline. Pain and discomfort using a verbal numeric rating pain scale at 5 times points during CVC insertion were assessed and analyzed.ResultsThe median interquartile range pain score is worst for placebo group after LAI (5 [3-6]) and in the immediate postprocedure period (5 [4-5]) which was significantly attenuated by addition of fentanyl (3.5 [2-5] and 3 [2-4]) (P = 0.009 and 0.001 respectively). Overall, fentanyl and placebo group were not statistically different with median discomfort score except at T10 (P = 0.047).ConclusionsPreprocedural bolus fentanyl infusion provides adequate analgesia and can be safely used for alleviating pain during CVC insertion in conscious patients.

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