Lidocaine use/ IV starts

[2rntish]

Is anyone using Lidocaine prior to an IV start? Is it a protocol or does it require a Dr order. EMLA works good but takes too long. We have briefly tried the spray on stuff with mixed results.

[ageless]

I have used it, but it requires a DR. order. studies have shown that bacteriostatic saline can work just as well and this does not require a physician's order.

--------------------------------------------------------------------------------

Bacteriostatic Saline as a Local Anesthetic

Patient and Family Version

Cathy Smith RN

Edited by Karen Bachman

Many people have heard of novocaine or lidocaine as local anesthetics. Many have experienced that unpleasant 'sting' when the lidocaine or novocaine is injected prior to stitches, wart or mole removal, dental procedures, or IV starts.

An alternative could be bacteriostatic saline with benzyl alcohol as a local anesthetic prior to the novocaine or lidocaine injection. Bacteriostatic saline is virtually painless and offers 2-5 minutes of local anesthetic. The lidocaine or novocaine is then injected and you don't have that unpleasant 'sting'. If the removal of the wart, stitches, or dental procedure is not too deep or too long, the bacteriostatic saline can be used by itself. The bacteriostatic saline can also be used by itself for IV starts.

When discussing a procedure using lidocaine or novocaine with your healthcare provider mention the bacteriostatic saline. Quite possibly he/she will try it and the 'sting' will be gone.

REFERENCE LIST

Silberg, B., (1992). Bacteriostatic Saline as a Means of Reducing the Pain of Injecting

Xylocaine. Plastic and Reconstructive Surgery, 89(4), Letter to the Editor, p.762.

Lugo-Janer, G., Padial, M., & Sanchez. J., (1993). Less Painful Alternatives for Local Anesthesia. Journal of Dermatologic Surgery, (19), 237-240.

Holmes, H., (1991). Options for Painless Local Anesthesia. Postgraduate Medicine, 89(3), 71-72.

Swinehart, J., (1992). The Ice-Saline-Xylocaine Technique. Journal of Dermatologic Surgery (18), 28-30.

[pauls-gal]

We are permitted to use lidocaine without a physician order. For our midline/PICC insertions we use Elamax. We wait 20-30 minutes after it has been applied.

[pollux, RN]

We use Ametop and have to wait only 20-30min. It works nicely .