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Warm lidocaine/tetracaine patch versus placebo before pediatric intravenous cannulation: a randomized controlled

Adam J Singer1, Breena R Taira, Ernest N Chisena

  • 1Department of Emergency Medicine, Stony Brook University, Stony Brook, NY 11794-8350, USA. adam.singer@stonybrook.edu

Annals of Emergency Medicine
|April 9, 2008
PubMed

Insights

Topical lidocaine/tetracaine patches modestly reduced pain during intravenous cannulation in pediatric emergency department patients. The treatment did not affect the success rate of IV insertions.

Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Anesthesiology

Background:

  • Intravenous (IV) cannulation is a common and often painful procedure for pediatric patients in emergency departments (EDs).
  • Effective pain management is crucial to improve patient experience and cooperation during medical procedures.

Purpose of the Study:

  • To compare the efficacy of a topical lidocaine/tetracaine patch versus placebo in reducing the pain associated with IV cannulation in pediatric ED patients.
  • To test the hypothesis that the active patch would reduce pain by at least 15 mm on a visual analogue scale.

Main Methods:

  • A randomized, double-blind, placebo-controlled trial was conducted in a suburban academic ED.
  • Eligible patients (3-17 years) received either a topical lidocaine/tetracaine patch or a placebo patch before anticipated IV cannulation.
  • Pain was measured using a visual analogue scale or Wong Baker scale post-cannulation.

Main Results:

  • A total of 45 patients were randomized; 40 underwent IV cannulation. The median pain score was significantly lower in the lidocaine/tetracaine group (18 mm) compared to the placebo group (35 mm; P=.04).
  • Adequate pain relief was reported by 75% of patients in the active treatment group versus 35% in the placebo group.
  • The success rate of IV cannulation on the first attempt was similar between the groups (90% vs. 85%).

Conclusions:

  • Topical lidocaine/tetracaine patches provide a modest reduction in IV cannulation pain for pediatric ED patients.
  • The application of these patches did not negatively impact the success rate of IV cannulations.
Abstract

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