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Created October 27, 2024, last updated 20 days ago.
Collection: 167, Score: 2, Trend score: 0, Read count: 54, Articles count: 9, Created: 2024-10-27 02:58:47 UTC. Updated: 2024-10-27 03:12:09 UTC.Notes
Yes! Despite anaesthesiologist and anaesthetist reluctance to infiltrate with lignocaine/lidocaine before peripheral cannulation, we have several decades of evidence showing that:
- The pain of subcutaneous 1% lignocaine injection is significantly less than cannulation pain across all cannula sizes.
- Patients prefer pre-cannulation LA infiltration.
Daniel Jolley
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Collected Articles
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Randomized Controlled Trial Clinical Trial
Local anaesthetic: does it really reduce the pain of insertion of all sizes of venous cannula?
The pain of subcutaneous 1% lignocaine injection is significantly less than cannulation pain across all peripheral cannula sizes down to 22-gauge.
pearl -
Randomized Controlled Trial Clinical Trial
The use of pre-cannulation local anaesthetic and factors affecting pain perception in the emergency department setting.
To determine whether the use of subcutaneous local anaesthetic (lignocaine) is associated with a reduction in cannulation pain in the emergency department setting. ⋯ The use of lignocaine before cannulation reduced cannulation pain in the emergency department setting. Other factors examined did not influence pain perception.
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Comparative Study
Appropriate use of local anaesthetic for venous cannulation.
A departmental survey indicated that the large majority of anaesthetists believed that injection of local anaesthetic before insertion of an intravenous cannula was unnecessary if a cannula of 18 gauge or smaller was used, because injection of local anaesthetic would be more painful than insertion of the cannula. A study was undertaken to test this hypothesis. The results showed that intravenous cannulation with a cannula of 18, 20 or 22 gauge was significantly (p less than 0.006) more painful than a subcutaneous injection of 1% lignocaine. We recommend that subcutaneous injection of local anaesthetic should be considered before insertion of any size of intravenous cannula.
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Patients' pain experiences with peripheral i.v. insertions, with and without the use of lidocaine for anesthesia, were described and compared. Patients reported their preferences related to the use of intradermal lidocaine with future i.v. insertions.
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Clinical Trial Controlled Clinical Trial
Pain during insertion of peripheral intravenous catheters with and without intradermal lidocaine.
Phase 1 of this study evaluated the perception of pain in 50 patients undergoing peripheral venous catheter insertion without the use of a local anesthetic. Phase 2 evaluated perceived pain in 50 patients who received intradermal lidocaine before the i.v. catheter was inserted. ⋯ No additional time (determined in intervals of 15 minutes) was required for the study group. Based on these findings, the hospital policy was modified so that intradermal lidocaine would be offered to all patients requiring peripherally inserted i.v. catheters.
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J. Perianesth. Nurs. · Aug 2013
What is the least painful method of anesthetizing a peripheral IV site?
The placement of an intravenous (IV) catheter for the administration of fluids, blood products, and medications is a common intervention for surgical procedures and perianesthesia patients. Although the placement of a peripheral IV may be routine for perianesthesia nurses, it is important to address the patient's level of pain related to the procedure. One technique to diminish the discomfort associated with the IV insertion is anesthetizing the site. ⋯ The findings demonstrate that there was no statistical difference in pain when anesthetizing the site using the three methods. However, there was a difference with the IV insertion process. Using 1% lidocaine resulted in the least painful IV insertion.
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Randomized Controlled Trial Comparative Study Clinical Trial
The pressor response to venous cannulation: attenuation by prior infiltration with local anaesthetic.
We have compared the cardiovascular response to insertion of an 18-gauge venous cannula in 40 healthy patients. In 20 of the patients, cannulation was preceded by infiltration of local anaesthetic. ⋯ We conclude that there is a significant pressor response to venous cannulation which is obtunded by prior infiltration with local anaesthetic. We recommend, therefore, that s.c. injection of lignocaine should be considered before insertion of an i.v. cannula, especially in the high risk patient.
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Anaesth Intensive Care · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialRationalizing venepuncture pain: comparison of lignocaine injection, Butterfly (21 gauge and 23 gauge) and Venflon (20 gauge).
Two hundred and seventy-eight patients scheduled for all types of surgery and premedicated with diazepam and metoclopramide were randomly allocated to one of four groups to compare the relative pain of an injection of 0.25 ml of lignocaine 1% via a 25 gauge needle with the pain of the siting of a 21 gauge Butterfly (Abbott), 23 gauge Butterfly or a 20 gauge Venflon (Vigo Spectramed). The injection of lignocaine and insertion of the 23 gauge Butterfly were associated with the least complaints of pain and least observed responses to pain. The 21 gauge Butterfly and 20 gauge Venflon were associated with complaints of greater pain and more pain responses. We conclude that a pre-cannulation injection of lignocaine causes minimal discomfort and is the most appropriate means of reducing the discomfort of venous cannulation when not using skin penetrating analgesic creams.
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A questionnaire study was undertaken to assess the influence of recently published, simple and conclusive research on the practice of anaesthetists in four centres. The research had clearly demonstrated the benefit of subcutaneous infiltration of local anaesthetic in reducing the pain of intravenous cannulation. Of the 81% who responded, 71% were aware of the research; 43% of these anaesthetists had altered their clinical practice as a result of the research and 73% used local anaesthesia for cannulae of 18 gauge or less, compared with only 46% of those who were unaware of the research. ⋯ Senior house officers were significantly less likely to be aware of the research than other grades. Anomalies were identified between the apparent awareness of the research and routine practice agreeing with the study findings. The value of research and the incorporation of clinical findings into everyday practice is discussed.