Is using lidocaine really effective during venipunture?

[digger]

I am a fairly new nurse that has transferred to a different organization whose policy is to use lidocaine transdermally before perpherial IV insertion. Is this really effective because I have never done this before and it seems like it is more work than it is worth, it seems that risk for infections could be higher with two sticks instead of possibly just one, and the research I've done says that the pain is usually in the patient's head (fear of needles) while other articles say that it really reduces pain. Can anyone help shed light on this issue for me. Is using lidocaine transdermally truely effective or is it just a placebo?

[dianah, ASN]

Anecdotally, 98% of the patients for which I used pre-IV stick lido (1%, small wheal just where I'd be sticking the needle into the skin),

* were pleasantly surprised at the results (small needle stick, a little burning cf large needle stick)

* stated they were very grateful for use of the lido.

Background: Used to work in CT scan, starting over 20 IVs per day X 20+ years for out-pt scans. Some folks were so freaked out by the very idea of the needle that they'd tense up and the IV was harder to start. Using lido made them more comfortable (their words, not mine) and my job MUCH easier (no moving targets, no gasping or crying in pain).

I use the lido as often as I can.

Granted, some ppl would rather not have it. No problem, I won't use it. BTW, I always asked first, telling the pts what to expect and giving them a choice.

[VivaLasViejas, ASN, RN]

I questioned the effectiveness of lidocaine until a few years ago, when surgery started becoming a semi-regular occurrence for me. Now I don't let anyone near me without it---I'm a hard stick, with deep, rolling/collapsing veins that run away at the mere approach of an angiocath. Sometimes it takes as many as half a dozen attempts before someone can get the thing in, and then it'll blow as soon as he or she tries to flush; with lidocaine, however, my veins never see it coming, and the nurse can almost always get it in one try.:)

[Dixiecup]

I work with a woman (she's not a nurse, works in the office) who has had several same day surgeries as of late. She swears by it.

[elephant4]

Very effective! I was trained to start IV's using this technique and over the past 20 years I have mostly worked ER, but now am in radiology where I still start lots of IV's and people constantly thank me for the lidocaine. Many times they don't even feel it with the 29 ga insulin needle I use to inject it. I have tried saline which does very little to help discomfort and plain 1% lidocaine, but prefer the buffered 1% which is practically painless.

Does anyone know if the radiology techs can use this technique, or is it strictly to be used by nurses? It is a medication so I wondered if that is possible or not. I am sure we could write a policy that covers it if needed and have it approved by our medical director. What do you all know about that?

[S.N. Visit, BSN, RN]

no one is taking my blood without numbing me up first! IV insertion is painful esp, since I have little rollie veins...........

[twinkerrs]

The hospital I am doing clinicals at uses lido to start ivs or draw blood as hospital policy. all the patients I talked to about it in pre op really felt more comfortable b/c of it.

[Indy, LPN, LVN]

For the procedure I had recently the preop nurse did use lido prior to the IV. She said they do that because of the 18g needle size for the IV. The lido hurt worse than an IV but it didn't give me any problems afterwards, and healed nicely when all was pulled out later that day.