Pain Attenuation During Peripheral Venous Catheterisation and Venipuncture Among an African Study Population: A Narrative Review.

Abstract

Introduction:Pain associated with peripheral venous catheter (PVC) insertion and venipuncture can be a significant source of discomfort, particularly for children. The use of topical anaesthetic preparations before PVC insertion can reduce discomfort and enhance health-seeking behaviour. Objective:This review was aimed at assessing the efficacy of topical anaesthesia to reduce pain during PVC insertion compared to placebo or no treatment, and the associated adverse effects with the use of topical anaesthetic preparations among the African population. Methods:This review was conducted using a systematic literature search of the following databases and registers:: PubMed, NDLTD, OATD, TROVE, LILACS, Scopus, The Cochrane Library, CINAHL & MEDLINE [via EBSCOhost], Africa Journal Online (AJOL), Google Scholar, and MedNar was conducted between November and December 2023. Prospective observational studies, randomised controlled trials, case-control studies, longitudinal studies, theses and dissertations were considered in these searches. A total of four studies and 448 respondents participated in the review. Result:All studies investigated the efficacy of various topical agents, including 5% EMLA and 10% lidocaine cream, and demonstrated a significant reduction in pain with topical anaesthesia compared to placebo or no treatment. The adverse/side effect profile was generally favourable, with no major adverse reactions reported. Conclusion:Topical anaesthesia is a valuable tool in reducing procedural pain during peripheral venous catheterization and venipuncture in the African population. This review establishes its superiority over placebo or no treatment. Specifically, 10% lidocaine outperforms 5% EMLA in minimizing procedural pain with minimal side effects. Further research is needed to explore alternative preparations for cases of adverse reactions and ineffective anaesthesia.