Is using lidocaine really effective during venipunture?

Dixielee, BSN, RN · Jun 30, 2006

Are you talking about injecting lido just under the skin, or topically like EMLA cream? They both have their place, but I rarely use either. I will use EMLA on a kid if I have 30-45 minutes to wait for it to work. I only use lido if the patient requests it. IT is not a placebo because it will numb up the area, but it burns and I think might hurt more than just the stick itself. It also sometimes masks the spot where I have found the vein making it a more difficult stick.

I know a lot of new nurses feel more comfortable using it in case they have to "dig" a little for the vein, but if you are confident in your vein, I say no lido.

If it is policy, you may not have any choice, but I would rather just go without it.

jmgrn65, RN · Jun 30, 2006

lido does burn I have had IV's started on me with and without, I prefer without. its extra stick and it burns.

digger · Jun 30, 2006

Thanks for helping out you all!

PANurseRN1 · Jun 30, 2006

I offer it. Some pts. want it, some don't. I had to get used to doing, but now it doesn't affect my success rate.

I think it's really a benefit for pts. who are very apprehensive about IV starts. Buffered lido is better--no burning (and I can attest to this from personal experience).

palesarah · Jun 30, 2006

lido does burn I have had IV's started on me with and without, I prefer without. its extra stick and it burns.

And I'm just the opposite- I prefer with. The "bee sting" of the lido to me is far more tolerable to me than the discomfort of the IV stick, even a stick by the best IV start.

The majority of patients I cared for who had had IVs with and without (this is when I was still working with adult patients who could tell me such, of course) preferred the lido as well- according to both the patients while they were in the hospital and the patient satisfaction surveys they returned after discharge. In fact, hospital policy in one facility was changed to make it mandatory to offer lidocaine or bacteriostatic NS for local before an IV start based on the info from the surveys (before it was hospital policy, it was standard practice in some units, nurse preference in others)

truern · Jun 30, 2006

If you're starting MY iv, I want lido. I have horrible deep veins so drawing blood or having an iv is a major ordeal

jmgrn65, RN · Jun 30, 2006

or bacteriostatic NS for local....)

Help me understand How does NS help with the pain of IV stick, especially since ns burns so much. Just asking cause I never heard of that.

PANurseRN1 · Jun 30, 2006

From what I've read, the wheal itself decreases the pain of the stick. There were some studies that showed no difference between lido and NS in terms of making an IV start less painful. There was a long thread in the CRNA forum that discussed this issue in depth.

https://allnurses.com/forums/f16/lidocaine-prior-iv-start-152733.html

RemoteRN · Jun 30, 2006

If you're starting MY iv, I want lido. I have horrible deep veins so drawing blood or having an iv is a major ordeal

So the phelebotomist puts down lido before drawing your blood?

TazziRN, RN · Jul 1, 2006

I will always use it on an adult who asks for it or a child, and even if they don't, if I use a large bore I will use it. If someone is about to poke me with an 18 or larger and I am not in extremis, I ask for a local. The fear of needles may be in one's mind, but I vcan pretty much gaurantee that the larger the bore, the more the pain.

mommy2boys · Jul 1, 2006

I'm not a nurse yet, but I have had a ton of iv's with and w/o lido. If I have a choice I will always opt for the lido. I'm a terrible stick and the small amount of pain that goes w/ it is worth it in the long run.

JMO

Erin