Initial Clinical Experience of a Novel Device (the ÒFriend CatheterÓ) for Local Anesthetic Delivery Around Indwelling...

The removal of femoral arterial sheaths, particularly after they have been in place for some hours, is a source of pain for patients undergoing invasiveive cardiac procedures. Methods of reducing this pain include systemic sedatives, analgesics and local anesthetic. We tested a new disposable plastic device, called the ÒFriend,Ó designed to reduce pain associated with sheath removal. The Friend wraps around a standard 8 Fr sheath allowing local anesthetic infiltration through side holes into local tissue. METHODS: Seventy-two patients undergoing interventional procedures were randomized to 3 groups for anesthetic administration just prior to sheath removal. Group 1 (control) received no local anesthetic. Group 2 (local) received 10 ml of lignocaine directly infiltrated with syringe and needle around the sheath. Group 3 (Friend) had the Friend inserted with the sheath and 10 ml of lignocaine was delivered via the device. Pain around the sheath was assessed prior to, during and just after, sheath removal using a 5 point verbal scale. RESULTS: Sixty-two patients completed the study. There were no serious complications related to the Friend device. The Friend group patients had significantly less pain associated with sheath removal than the control group. (Mean pain difference 1.28 vs. 0.34, p = 0.04). Pain scores in group 2 (local) did not differ significantly from the control group. The additional estimated cost involved in using the Friend was $16.93 per patient. CONCLUSIONS: The Friend device is a new, inexpensive and safe method of reducing pain associated with removal of arterial sheaths after cardiac interventional procedures.