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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

317
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
317
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

80
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
80
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

396
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
396
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

551
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
551
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

889
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
889
Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

364
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
364

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Updated: May 8, 2025

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Reducing Pain With IV Insertion Using a Needleless Anesthetic Device in the Pediatric Ambulatory Surgery Unit.

Lisa Schaeg Merritt1, Catherine Sweet1, Jaiden Newman1

  • 1Cardinal Glennon Children's Hospital, Saint Louis, MO.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|March 28, 2025
PubMed
Summary

This quality improvement project successfully reduced pediatric IV insertion pain by 72% using needleless anesthetics. The study demonstrates an effective strategy for improving pediatric ambulatory surgery care.

Keywords:
IV insertionambulatory surgeryneedleless anestheticpediatric

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Area of Science:

  • Pediatric Anesthesiology
  • Quality Improvement Science
  • Pain Management

Background:

  • Pediatric patients undergoing ambulatory surgery often experience significant pain during intravenous (IV) insertion.
  • Effective pain management is crucial for a positive patient experience and successful surgical outcomes.
  • Current practices may not adequately address procedural pain in pediatric ambulatory settings.

Purpose of the Study:

  • To decrease pain scores associated with intravenous (IV) insertion by 50% within two months.
  • To improve the care quality for children in a pediatric academic hospital's ambulatory surgery center.
  • To implement evidence-based interventions for procedural pain reduction.

Main Methods:

  • A quality improvement project utilizing Plan-Do-Study-Act (PDSA) cycles.
  • Implementation of an evidence-based needleless anesthetic (J-Tip with 1% buffered lidocaine).
  • Collection of baseline and post-intervention data on pain scores and IV attempts.

Main Results:

  • Mean pain scores during IV insertion decreased by 72%, from 5.3 to 1.5 (P < .05).
  • A statistically significant reduction in pediatric procedural pain was achieved.
  • A slight decrease in the number of IV attempts was observed (1.47 to 1.35).

Conclusions:

  • The quality improvement project significantly enhanced care quality for pediatric patients.
  • Needleless anesthetic devices effectively minimize pain associated with IV insertions.
  • Implementing evidence-based strategies creates a less intimidating environment for pediatric patients.