Rationalizing Venepuncture Pain: Comparison of Lignocaine Injection, Butterfly (21 Gauge and 23 Gauge) and Venflon (20 Gauge)

Berg, A. A. Van Den; Prabhu, N V

doi:10.1177/0310057x9502300207

“…Previous studies have found a complex relation between sex and pain, some suggesting a diVerence with men reporting less pain, others have contradicted this and some have found no diVerences. 4 17 18 Our study found the mean pain scores for men and for women were not significantly diVerent, and there was no correlation with age. One explanation for this might be that the way we express pain is culturally dependent and varies with age and sex even though the level of pain perceived is constant.…”

Section: Discussionmentioning

confidence: 68%

The use of pre-cannulation local anaesthetic and factors affecting pain perception in the emergency department setting

Harris

¹

2001

Emergency Medicine Journal

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Study objective-To determine whether the use of subcutaneous local anaesthetic (lignocaine) is associated with a reduction in cannulation pain in the emergency department setting. Methods-Patients over 18 with a Glasgow Coma Score (GCS) of 15 and conversational English were allocated into one of three groups: Group 1 were cannulated after routine skin preparation; Group 2 received 1% lignocaine 0.1 ml via a 27 gauge needle and diabetic syringe before cannulation; Group 3 were injected as for Group 2 but saline was substituted for lignocaine. The cannulator and subject were blinded to the ampoule. The pain was measured using a 100 mm visual analogue scale. Setting-A large urban university hospital emergency department. Results-366 patients were recruited and the data on 322 analysed. Those receiving lignocaine before cannulation reported lower pain scores (1.9 cm) than the saline (4.1 cm) or immediate cannulation (3.6 cm) groups, p<0.0001. Other factors such as the experience of cannulator, patient characteristics, the presence of a painful underlying condition and cannula size did not eVect pain scores. Conclusion-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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“…Venipuncture pain is effectively reduced by 1% lignocaine infiltration [17,18], which in itself causes only minimal discomfort. Venipuncture pain is effectively reduced by 1% lignocaine infiltration [17,18], which in itself causes only minimal discomfort.…”

Section: Discussionmentioning

confidence: 99%

Use and safety of percutaneous tracheostomy in intensive careReport of a postal survey of ICU practice

Cooper

¹

1998

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Percutaneous tracheostomy using a graded dilatation technique was described by Ciaglia in 1985 [1]. The description of other techniques using special forceps to dilate the trachea followed. The safety and low early complication rate of percutaneous tracheostomy compared with open surgical tracheostomy have been established by several prospective studies [2][3][4][5][6][7].The long-term complications, such as tracheal stenosis, remain a source of controversy. Conventional surgical tracheostomy has been associated with a long-term tracheal stenosis rate of between 16 and 64% [2, 8]. Studies using tomography [2] and fibreoptic laryngotracheoscopy [9, 10] have shown low stenosis rates with percutaneous tracheostomy.This postal survey was designed to assess the practice and attitudes to percutaneous tracheostomy in intensive care. Questions were included on the use of fibreoptic bronchoscopy and long-term follow-up. MethodsIn 1997, a postal survey was sent to the clinical directors of 231 general intensive care units in England and Wales.Specialist units, such as pure neuro-surgical or cardiac units were not surveyed. The recipients were requested to fill in a short and simple questionnaire (Appendix). The results were statistically analysed using the Chi-squared test. A p value less than 0.05 was considered statistically significant. ResultsQuestionnaires were returned by 176 out of 231 intensive care units, yielding a 76% response rate. Of the 176 directors who replied, 129 (73.3%) used percutaneous tracheostomy as the method of choice for tracheostomies on their unit (Table 1). Only 32 (18.2%) had never used it. Six (3.4%) had stopped using the technique. In all, 78.4% were using the technique of percutaneous tracheostomy on their ICU patients. FibreoscopyIn seventy-one (49.3%) units, fibreoscopy did not feature as a routine part of the technique of percutaneous tracheostomy (Table 2) and in only 45 (31.3%) was it used routinely.

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“…A perplexing finding in this study was the lack of effectiveness of lignocaine infiltration compared with placebo. Venipuncture pain is effectively reduced by 1% lignocaine infiltration [17,18], which in itself causes only minimal discomfort. The explanation of this discrepancy between spinal puncture and venipuncture may be twofold, the different solution and the different injection site.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of remifentanil for control of haemodynamic response to tracheal intubation

McAtamney

¹

,

O'Hare

²

,

Hughes

³

et al. 1998

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Percutaneous tracheostomy using a graded dilatation technique was described by Ciaglia in 1985 [1]. The description of other techniques using special forceps to dilate the trachea followed. The safety and low early complication rate of percutaneous tracheostomy compared with open surgical tracheostomy have been established by several prospective studies [2][3][4][5][6][7].The long-term complications, such as tracheal stenosis, remain a source of controversy. Conventional surgical tracheostomy has been associated with a long-term tracheal stenosis rate of between 16 and 64% [2, 8]. Studies using tomography [2] and fibreoptic laryngotracheoscopy [9, 10] have shown low stenosis rates with percutaneous tracheostomy.This postal survey was designed to assess the practice and attitudes to percutaneous tracheostomy in intensive care. Questions were included on the use of fibreoptic bronchoscopy and long-term follow-up. MethodsIn 1997, a postal survey was sent to the clinical directors of 231 general intensive care units in England and Wales.Specialist units, such as pure neuro-surgical or cardiac units were not surveyed. The recipients were requested to fill in a short and simple questionnaire (Appendix). The results were statistically analysed using the Chi-squared test. A p value less than 0.05 was considered statistically significant. ResultsQuestionnaires were returned by 176 out of 231 intensive care units, yielding a 76% response rate. Of the 176 directors who replied, 129 (73.3%) used percutaneous tracheostomy as the method of choice for tracheostomies on their unit (Table 1). Only 32 (18.2%) had never used it. Six (3.4%) had stopped using the technique. In all, 78.4% were using the technique of percutaneous tracheostomy on their ICU patients. FibreoscopyIn seventy-one (49.3%) units, fibreoscopy did not feature as a routine part of the technique of percutaneous tracheostomy (Table 2) and in only 45 (31.3%) was it used routinely.

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Rationalizing Venepuncture Pain: Comparison of Lignocaine Injection, Butterfly (21 Gauge and 23 Gauge) and Venflon (20 Gauge)

Cited by 11 publications

References 7 publications

The use of pre-cannulation local anaesthetic and factors affecting pain perception in the emergency department setting

The use of pre-cannulation local anaesthetic and factors affecting pain perception in the emergency department setting

Use and safety of percutaneous tracheostomy in intensive careReport of a postal survey of ICU practice

Evaluation of remifentanil for control of haemodynamic response to tracheal intubation

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