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Administration of Local Anesthetic Agents to Decrease Pain Associated With Peripheral Vascular Access

Anderson, Steven BSN, RN; Cockrell, Jean BSN, RN; Beller, Pat MA, PhD, RN; Murphy, Elizabeth BSBA, RN, CEN; Nelson, Pat BSN, MSN, RN; Hawkins, Myra PharmD; Cederna-Moss, Joan MSN, RN

doi: 10.1097/NAN.0b013e3181f85628
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The purpose of this study was to compare a variety of local anesthetic agents before starting an intravenous (IV) device to determine which method is the most comfortable for patients. Using a randomized, double-blind, placebo-controlled, pretest-posttest experimental design, the study compared 5 treatment groups (anesthetic spray, placebo spray, anesthetic intradermal injection, placebo intradermal injection, and a control group with no local anesthetic agent) in 84 emergency department patients. Pain was measured with a visual analog scale before and after the application of the local anesthetic agents and after IV insertion. Pain was significantly higher in the anesthetic intradermal injection group 1 minute after anesthetic application compared with the other treatment groups. Pain ratings 3 minutes after IV insertion were found to be similar for the 5 treatment groups. These study results do not support the use of intradermal anesthetic agents before IV catheter insertion.

The purpose of this study was to compare a variety of local anesthetic agents before starting an intravenous (IV) device to determine which method is the most comfortable for patients. Using a randomized, double-blind, placebo-controlled, pretest-posttest experimental design, the study compared 5 treatment groups (anesthetic spray, placebo spray, anesthetic intradermal injection, placebo intradermal injection, and a control group with no local anesthetic agent) in 84 emergency department patients. Pain was measured with a visual analog scale before and after the application of the local anesthetic agents and after IV insertion. Pain was significantly higher in the anesthetic intradermal injection group 1 minute after anesthetic application compared with the other treatment groups. Pain ratings 3 minutes after IV insertion were found to be similar for the 5 treatment groups. These study results do not support the use of intradermal anesthetic agents before IV catheter insertion.

Staff Nurse, Emergency Department (Mr Anderson, Dr Beller, and Mss Cockerell and Murphy); Director, Emergency Department (Ms Nelson); Clinical Pharmacist (Dr Hawkins); Clinical Nurse Specialist, ICU (Ms Cederna-Moss), Rex Healthcare, Raleigh, North Carolina.

Corresponding Author: Steven T. Anderson, BSN, RN, Rex HealthCare, Raleigh, NC 27607 (steven.anderson@rexhealth.com).

Steven Anderson, BSN, RN, is a graduate of Davis and Elkins College, Elkins, West Virginia. He is currently an Emergency Department staff nurse at Rex HealthCare in Raleigh, NC. He is Principal Investigator and Past Chairman, Nursing Research Council, Rex Healthcare Emergency Department, Raleigh, NC. He has 23 years of professional nursing experience.

Jean Cockrell, BSN, RN, is a Graduate of East Carolina University, Greenville, North Carolina and the University of North Carolina-Chapel Hill. She is also a member of the Research Committee and Magnet Champion Committee at Rex Healthcare, Raleigh, North Carolina, and a member of ENA.

Pat Beller, MA, PhD, RN, has been in nursing practice at Rex Healthcare in Raleigh, North Carolina for more than 20 years. She earned her degree in Nursing in North Carolina after having worked for other graduate degrees in the Midwest. She is experienced in foreign language development, teaching, and several areas of hospital nursing.

Elizabeth Murphy, BSBA, RN, CEN, received her Nursing Diploma at St. Rita Hospital School of Nursing, Sydney, Nova Scotia, Canada, and a Bachelor of Science in business administration at Appalachian State University, Boone, North Carolina. She has many years of professional nursing, nursing management, and EMS education experience.

Pat Nelson, BSN, MSN, RN, is a graduate of East Carolina University, Greenville, North Carolina and a Masters Science Nursing graduate of the University of North Carolina-Chapel Hill. Currently she is Director of Clinical Operations at Memorial Health Care Systems, Colorado Springs, Colorado. She has 22 years of nursing experience in Emergency Department Nursing.

Joan Cederna-Moss, MSN, RN, is Interim Chief Nursing Officer at Franklin Regional Medical Center, Louisburg, North Carolina. At the time of this study, Joan was the Cardiovascular Services Clinical Nurse Specialist at Rex Healthcare. She has her Masters in Nursing Degree from The University of North Carolina in Greensboro and a BSN from Northern Michigan University in Marquette, Michigan.

© Copyright 2010 by the Infusion Nurses Society