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Original Research: Local Anesthesia Before IV Catheterization

Burke, Sandra Drozdz PhD, RN, APN-BC; Vercler, Sonia J. RN, CGRN; Bye, Ra'Net O. BSN, RN; Desmond, P Corinn BS, RN, CAPA; Rees, Yvonne W. RN, CGRN

AJN The American Journal of Nursing: February 2011 - Volume 111 - Issue 2 - p 40-45
doi: 10.1097/01.NAJ.0000394291.40330.3c
Feature Articles

Background Intradermal buffered lidocaine is known to be effective in producing local anesthesia prior to IV catheterization. Recently, intradermal bacteriostatic normal saline has been suggested as a possible alternative.

Objective To compare the efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization.

Methods In a randomized, double-blind, parallel-design, quasiexperimental study, we compared pain ratings of adult patients receiving either intradermal buffered lidocaine or intradermal bacteriostatic normal saline before IV catheterization. We measured pain at venipuncture through the use of a verbal numeric rating scale, used the test to compare group differences, and performed an analysis of covariance to test for outcome differences related to age, sex, and race or ethnicity.

Results The final sample (N = 148) was 65% women and 82% white, with a mean age of 52 years (range, 19 to 80 years). Demographic characteristics between the two treatment groups were similar. Intradermal buffered lidocaine was demonstrated to be significantly superior to intradermal bacteriostatic normal saline in reducing the pain of IV catheterization (P = 0.007). Differences in pain ratings between the two groups were not associated with age, sex, race or ethnicity, catheter size, or location of the IV site.

Conclusions Intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment.

Keywords intradermal bacteriostatic normal saline, intradermal buffered lidocaine, intravenous catheterization, local anesthesia, preintravenous local anesthesia

This article compares the efficacy of intradermal buffered lidocaine with that of intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization.

Sandra Drozdz Burke is director of the Urbana Regional Program for the College of Nursing at the University of Illinois at Chicago, in Urbana. Sonia J. Vercler is nurse manager on the same-day services, postanesthesia care, and pretesting units at Advocate BroMenn Medical Center in Normal, Illinois, where Ra'Net O. Bye is a charge nurse on the same-day services and postanesthesia care units, and Yvonne W. Rees and P. Corinn Desmond are staff nurses on the same-day services unit. (At the time this study was conducted, Sonia J. Vercler was a charge nurse at the medical center.) Contact author: Sonia J. Vercler, svercler@bromenn.org.

The authors of this article received a grant from the American Society of PeriAnesthesia Nurses (ASPAN) to help offset the cost of materials and travel expenses to present topics related to this study at the ASPAN 2009 national conference. LWW has resolved any actual or potential conflicts of interest regarding this educational activity for these authors.

The authors would like to acknowledge the same-day services staff for their participation in data collection: Dee Dee Black, PharmD, who prepared the study solutions; Christina Garcia for her assistance with data entry; Kevin Grandfield for his thoughtful comments on the manuscript; and Dava Brown, who generously shared her original protocol.

© 2011 Lippincott Williams & Wilkins, Inc.