Lidocaine with Rocephin?

[HikingEDRN, BSN, RN]

I've been in the ED for almost 3 years. We give Rocephin IM on a fairly regular basis. I have always asked for an order for lidocaine to reconstitute it instead of using sterile water. I was told by more experienced nurses when I started that it decreased the pain associated with the injection.

We have a new doc who is very nice but when I asked him for lidocaine, he looked very surprised and asked me why would we ever want to do that. He said that lidocaine stings on its own and he thought it would make it more painful. No biggie, I used sterile water but what I really want to know is have I been incorrectly advocating for my patients all this time by asking for a lidocaine order? I understand that lidocaine stings when injected but my impression has always been that it helps as the drug absorbs into the muscle.

My caveat is that this is an informal inquiry - I have not researched this subject. Just curious.

[sserrn, BSN]

I'm surprised that you need an order to mix it with lidocaine at your facility. As to your Q, I've always wondered of it really helps and kind of doubt it, but who knows!

[meanmaryjean, DNP, RN]

I'm surprised that you need an order to mix it with lidocaine at your facility. As to your Q, I've always wondered of it really helps and kind of doubt it, but who knows!

Lidocaine is a drug too- hence the needing an order for it. BUT- I do think it helps with the pain, as a Rocephin injection can hurt really badly for several hours, according to family members who've had it.

[floridaRN38]

Our ER we don't need a order to pull out 1% lido to mix with rocephin. We just all do it. But I have heard that it doesn't make that big of a difference for the pt. a shot is a shot. And it stings no matter what

[SweetMelissaRN]

I can say personal experience it is most definitely LESS painful. I've had both and I request the lidocaine with it... We keep a few bottles of lido out specifically to mix rocephin with so we don't need an order. Don't know scientifically if it was truly the lidocaine or the injector that made it hurt less, but my injection site when numb shortly after injection!

[HikingEDRN, BSN, RN]

I don't think our policy addresses it - I just grab an order so it will show up in the MAR and I can scan it. Thanks for your thoughts guys. It just seemed that this doc (he is a new attending) had never heard of such a thing and it had seemed pretty commonplace to me. I was just wondering if all those people that I had promised "it shouldn't hurt as much after awhile because of the lidocaine" were cursing me hours later for lying to them :)

[Sassy5d]

I've pretty much always mixed it with lido.. But, many of the nurses I work with tell me I'm too nice, that it would somehow encourage people to be more safe with sex, that they'd remember the burn.

[sapphire18]

I've pretty much always mixed it with lido.. But many of the nurses I work with tell me I'm too nice, that it would somehow encourage people to be more safe with sex, that they'd remember the burn.[/quote']

..???

[DialysisRN12]

..???

Poster is referring to STDs, more specifically gonorrhea, as the common reason for the rocephin shot.

[Madras]

I've pretty much always mixed it with lido.. But, many of the nurses I work with tell me I'm too nice, that it would somehow encourage people to be more safe with sex, that they'd remember the burn.

I might start mixing with sterile water now!

[AlaBro2010]

We give Rocephin mixed with Lidocaine also. The only time we give with sterile water is if they have an allergy to lidocaine or anything similar. We've always been told to use it to "ease the sting".

[sapphire18]

Poster is referring to STDs, more specifically gonorrhea, as the common reason for the rocephin shot.

Ah. When I worked in the ED my main memories of giving rocephin shots are to little kids:/