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Do we necessarily need local anaesthetics for venous cannulation? A comparison of different cannula sizes

Published online by Cambridge University Press:  23 December 2004

K. D. Röhm ,
T. A. H. Schöllhorn ,
M. J. Gwosdek ,
S. N. Piper ,
W. H. Maleck  and
J. Boldt
K. D. Röhm
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany
T. A. H. Schöllhorn
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany
M. J. Gwosdek
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany
S. N. Piper
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany
W. H. Maleck
Affiliation:
Spital Grenchen, Department of Anaesthesiology, Grenchen, Switzerland
J. Boldt
Affiliation:
Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany
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Abstract

Summary

Background and objective: This randomized, prospective study was performed to evaluate the efficacy of a subcutaneous local anaesthetic infiltration prior to venepuncture using different cannula sizes.

Methods: Three-hundred-and-one patients were included in the study, 150 received mepivacaine 1% (0.25 mL) subcutaneously, 151 were cannulated without local analgesia. Patients were further allocated to one of five cannula size groups (standard wire gauge (G)): 20-, 18-, 17-, 16- and 14-G. They were asked to quantify the pain experienced using a four-point rating scale.

Results: In the group without local anaesthetics, 28.8% complained about pain compared to 12% receiving local analgesia. The incidence of pain for 14-G (10%) and 16-G (12.9%) cannulae was significantly reduced in the local analgesia group (P < 0.01) compared to no local analgesia (77.4% and 45.1%). Other cannula sizes showed no difference in pain whether using local analgesia or not.

Conclusions: Patients profit from a subcutaneous infiltration with mepivacaine 1% prior to intravenous cathetherization only when cannulae of size ≥16-G are inserted.

Keywords

ANAESTHETICS, LOCAL, mepivacaineVEINS, VENEPUNCTURE, cannulation
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 3 , March 2004 , pp. 214 - 216
Copyright
2004 European Society of Anaesthesiology

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References

Van Wijk MGF, Smalhout B. A post-operative analysis of the patient's view of anaesthesia in a Netherlands' teaching hospital. Anaesthesia 1990; 45: 679–682.Google Scholar
Keep PJ, Jenkins JR. From the other end of the needle.The patient's experience of routine anaesthesia. Anaesthesia 1978; 33: 830–832.Google Scholar
Langham BT, Harrison DA. The pressor response to venous cannulation: attenuation by prior infiltration with local anaesthetic. Br J Anaesth 1993; 70: 519–521.Google Scholar
Harrison N, Langham BT, Bogod DG. Appropriate use of local anaesthetic for venous cannulation. Anaesthesia 1992; 47: 210–212.Google Scholar
Langham BT, Harrison N. Local anaesthetic: does it really reduce the pain of insertion of all size of venous cannula? Anaesthesia 1992; 47: 890–891.Google Scholar
Hopkins CS, Buckley CJ, Bush GH. Painfree injections in infants; use of a lignocaine–prilocaine cream to prevent pain at intravenous induction of anaesthesia in 1–5 year-old children. Anaesthesia 1988; 43: 198–201.Google Scholar
Soliman IE, Broadman LM, Hannallah RS, McGill WA. Comparison of the analgesic effects of EMLA (eutectic mixture of local anaesthetics) to intradermal lidocaine infiltration prior to venous cannulation in unpremedicated children. Anesthesiology 1988; 68: 804–806.Google Scholar
Smith M, Gray BM, Ingram S, Jewkes DA. Double-blind comparison of topical lignocaine-prilocaine cream (EMLA) and lignocaine infiltration for arterial cannulation in adults. Br J Anaesth 1990; 65: 240–242.Google Scholar
Raatz U. A modification of the White tests for large random samples. Biometr Zeitschr 1966; 8: 42–54.Google Scholar
Hallen B, Olsson GL, Uppfeldt A. Pain free venepuncture. Effect of timing of application of local anaesthetic cream. Anaesthesia 1984; 39: 969–972.Google Scholar
Selby IR, Bowles BJM. Analgesia for venous cannulation: a comparison of EMLA (5 minutes application), lignocaine, ethyl chloride, and nothing. J Roy Soc Med 1995; 88: 264–267.Google Scholar
Gershon RY, Modriski BK, Matjasko MJ. Intradermal anesthesia and comparison of intravenous catheter gauge. Anesth Analg 1991; 73: 469–470.Google Scholar
Prien T. Intradermal anaesthesia: comparison of several compounds. Acta Anaesth Scand 1994; 38: 805–807.Google Scholar
O'Connor PJ, Caldicott LD. Local anaesthesia and venous cannulation. Anaesthesia 1995; 50: 1005.Google Scholar
Holdgate A, Wong G. Does local anaesthetic affect the success rate of intravenous cannulation? Anesth Intens Care 1999; 27: 257–259.Google Scholar