Factors affecting pain in intravenous catheter placement: role of depression illness

The aim of the study was to examine factors affecting pain during intravenous (IV) catheter placement in an emergency department. A cross-sectional, observational study was conducted at an academic emergency department. Nine hundred and twenty-five adult patients who had a 20-gauge IV catheter placed were enrolled in the study. Patients were excluded for the following conditions: more than one IV attempt, altered mental status, head trauma, lack of contact due to visual impairment, hearing or speech disorder, intoxication, distracting injury or physical abnormality at the IV site. The magnitude of pain in IV catheter placement was not related to age, sex, experience of the individual placing the IV catheter, site of IV catheter insertion and use of analgesic or antidepressant drugs (p > 0.05). Patients with a history of depression reported significantly higher pain than non-depressed patients (p = 0.001). Depressed patients reported higher severity of pain during IV catheter placement than non-depressed ones. This may influence the decision on whether or not to use local anaesthesia for catheter insertion.