Effect of intradermal anaesthesia on success rate and pain of intravenous cannulation: a randomized non-blind crossover study

Abstract

Intravenous cannulation is a commonly performed procedure. This study aimed to determine whether the success rate and pain of intravenous cannulation is affected by prior injection of intradermal lidocaine. Intravenous cannulation was performed twice in 45 healthy volunteers. Intradermal lidocaine was administered prior to one of these cannulations. The outcome measures were success or failure of cannulation, and pain of cannulation, measured with a 100 mm visual analogue pain scale. The success rate of intravenous cannulation with and without prior intradermal lidocaine was 54% and 76%, respectively. The difference was 22.0% (95% CI 1.5-27.8%; P = 0.03). Log-linear analysis for three-way interaction between the variables (outcome, vascular condition and use of lidocaine) showed a significant influence of vascular condition on outcome (G(2) 24.6, P < 0.001). The mean (SD) pain scores in the control and intervention group were 34.8 (21.0) and 13.6 (13.2) mm, respectively. The difference between the mean pain scores was 21.2 mm (95% CI 15.1-27.3 mm). In conclusion, the success rate of intravenous cannulation may be reduced with the use of intradermal lidocaine, but success rate is primarily dependent on vascular condition. Intradermal lidocaine achieves a clinically significant reduction in the pain of intravenous cannulation.

Pain During Venous Cannulation

“…A recent network meta-analysis directly or indirectly compared lidocaine application with 16 further analgetic interventions before peripheral venipuncture and found that 2% lidocaine was most effective (5). However, this procedure is time-consuming (7); it can result in a higher rate of puncture failures (15,16), and of itself causes pain (8)(9)(10)16).…”

Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial

“…Within the trial, the 18G catheter was inserted according to the provider’s usual technique after skin cleaning without local anesthesia [which can impact insertion success 21 and its administration can also cause pain 7 ]. The provider was instructed to insert in the non-dominant arm if a suitable vein was available and to avoid veins at the antecubital fossa or upper forearm where the catheter tip will extend to the elbow crease after insertion.…”

Comparative Study of the Effectiveness of Vapocoolant Spray Versus EMLA Cream in Reducing Pain During Intravenous Cannulation in the Adult Population

“…cannulation is a prerequisite before any major or minor procedure. It is an invasive approach wherein a catheter is introduced into the lumen of a peripheral vein through the patient's skin (1). The pain and discomfort due to intravenous cannulation produce anxiety and stress for anyone and may lead to future negative ramifications like non-willingness for likely upcoming hospital admissions (2,3).…”