Xylocaine for Port Access

  1. We have a running debate at my facility regarding port access for our chemo pts. Some nurses prefer numbing with a xylocaine injection, some spray. The injection may increase the risk of infection due to an additional stick? Is the spray actually sterile? I know some places (especially hospitals) use nothing. I am interested in hearing what other Outpatient Cancer Centers do and based on what information.
    •  
  2. 12 Comments

  3. by   Kim O'Therapy
    The facility my husband goes to for treatment prescribed Lidocaine/Prilocain Cream 2.5%. He massages into the skin covering his port 30 to 40 minutes before access and he has wonderful results.

    Good luck.
  4. by   Nurse_Diane
    We use EMLA cream at our facility. We instruct the pt to put in on 60 min. prior to their port being accessed.
  5. by   ORSmurf
    We offer our patients a xylociane injection. I'd say it's half and half as far as how many prefer it. We don't have the spray or emla cream options.
  6. by   lbwrn
    We use the spray at our facility. Less than half of our patients use the spray.
  7. by   Sailingshoes
    Thanks for the replies! I forgot to mention we do prescribe Emla Cream as well but for some pts it's too much too remember therefore the question of spray vs. stick.
  8. by   prowlingMA
    The Center I work at will perscribe cream only if pt has a lot of pain with access. And only uses the spray if the patient requests. Lidocaine rarely used, some times if it is the first time being accesses after placement. Probably 75% of the time they don't use anything.
  9. by   scma
    Our practice will give a Rx for Emla for the patient to apply at home. 95% of our patients use nothing at all. We use 22G hubers only. When I access patients they all say it is not as bad as they brace themselves for.
  10. by   iluvivt
    The spray you are talking about is Ethyl Chloride and can be used to freeze the skin prior to port access. It is an accepted practice. I would apply the spray and allow it to dry,then cleanse the skin,(preferably with Chlorhexadine) for 30seconds and allow that to air dry (air drying is mandatory in order for it to work properly) and then proceed in sterile fashion. As far as the injection,I assume you are using a 1% Lidocaine and this is also acceptable practice as well. Be aware that over time with repeated access the skin over the port becomes desensitized. We rarely use anything,unless patient is difficult to access or if they are very frightened about the stick and can not calm down.
  11. by   Beaches10
    We gave our patients the choice of xylocaine vs nothing, both peripheral and via port. About 4% chose not to use Xylocaine while 96% state it makes the experience better. Only 2% felt the topical was worth the trouble of remembering to apply. I'm torn - topical would be worth it with a port if it were me, unpredicatable as far as a peripheral site access. Infection at the port site is rare, so can't say the extra stick with Xylocaine use would be a true factor.
  12. by   estralita
    Will there be a chance of damaging to the silcone surface of the port if u use inj xylocaine?
  13. by   MissRNC
    We use 0.5% lidocaine intradermally prior to port access. Most of our pt's request it with the exception of our sickle cell pt's that have had their ports for years.
  14. by   blondy2061h
    We rarely use ports, but we use EMLA if we are going to access them. Most patients seem to prefer the EMLA cream, but almost all of them have had their port accessed at some point without it and say it's not too bad.

close