What is the Least Painful Method of Anesthetizing a Peripheral IV Site?

ABSTRACT 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 purpose of this study was to compare three methods for anesthetizing peripheral IV catheter sites before insertion to determine which method provides optimal patient comfort during the anesthetizing and IV catheter insertion process. 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.

  • The American Journal of Nursing 10/1997; 97(9):20. · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study compared the efficacy of a common medication diluent, bacteriostatic 0.9% sodium chloride containing the preservative benzyl alcohol with lidocaine hydrochloride 1% as an intradermal pretreatment for the relief of pain associated with intravenous cannulation. Forty adult presurgical patients requiring two large bore intravenous catheters were used. They served as their own controls. The inner aspect of one forearm received the usual pretreatment, lidocaine hydrochloride 1%, and the inner aspect of the opposite arm received intradermal pretreatment with bacteriostatic 0.9% sodium chloride with the preservative benzyl alcohol. Intravenous cannulation was accomplished on the first attempt, and pain reported with cannulation was rated using a visual analogue scale (VAS). A paired t test was used to compare differences in VAS scores with the pretreatment bacteriostatic 0.9% sodium chloride containing the preservative benzyl alcohol with the pretreatment lidocaine hydrochloride 1%. Analysis of the data revealed no significant difference in the report of perceived pain of intravenous cannulation based on the intradermal pretreatment. These findings suggest that intradermal bacteriostatic 0.9% sodium chloride containing the preservative benzyl alcohol is as effective as intradermal lidocaine hydrochloride 1% in the attenuation of intravenous cannulation pain.
    AANA journal 01/1999; 66(6):583-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study compared pain on application, pain on venipuncture, cost, and convenience of 4 analgesic agents used for venipuncture. A convenience sample of 280 preoperative subjects was assigned randomly to 1 of 4 groups. Group 1 received 2.5% lidocaine--2.5% prilocaine cream (LPC) topically, Group 2 received dichlorotetrafluoroethane spray (DCTF), Group 3 received 0.5% lidocaine subcutaneously, and group 4 received normal saline with 0.9% benzyl alcohol (BA) subcutaneously. A 7-point verbal descriptor scale measured pain on application, and a 100-mm visual analogue scale measured pain on venipuncture. Cost was measured and compared on unit-dose basis. Convenience was measured with a questionnaire survey completed by the investigators. There was no significant difference (P < .05) among the groups for age, sex, ASA physical status, or difficulty of venipuncture. There was a significant difference in pain on application for all 4 agents (P < .05). The DCTF had the highest pain on application score (1.7 +/- 0.1), while the LPC had no pain on application (0.0 +/- 0). Lidocaine had a higher pain on application score (1.08 +/- 0.1) than the BA (0.52 +/- 0.1) but a lower score than DCTF. Lidocaine (1.3 +/- 0.3) was significantly less painful (P < .05) on venipuncture than LPC (2.18 +/- 0.3) and DCTF (2.5 +/- 0.3) but was not significantly different than BA (1.92 +/- 0.3). (All scores are given as mean +/- SEM.) There was a significant difference in cost and convenience among the 4 agents, with BA and lidocaine being the least expensive analgesic agents. Lidocaine, DCTF, and BA were equally convenient to use, while LPC was the least convenient, (P < .05). Lidocaine had low pain on venipuncture and low cost and convenience of use, but it was less than ideal in terms of pain on application. The BA had all the qualities of an ideal analgesic agent for venipuncture in this sample and should be considered as an analgesic agent for venipuncture.
    AANA journal 02/2000; 68(1):43-51.