Pain Management in Arterial Blood Gas Sampling: Prevalence of Anesthetic Use and Associated Factors in Spain

Arterial blood gas analysis is a fundamental diagnostic procedure for evaluating respiratory function, yet patients frequently perceive it as 1 of the most painful techniques. Although major scientific societies and clinical practice guidelines recommend the subcutaneous infiltration of local anesthesia before puncture, its implementation remains limited. This study aimed to explore the prevalence of local anesthetic use before arterial puncture and nurses' attitudes around the use of preprocedure local anesthetic across 3 hospital units.

A descriptive cross-sectional study was conducted between January and May 2023. Nurses providing direct patient care in respiratory outpatient clinics, respiratory inpatient wards, and the emergency department were invited to participate. Data were collected through an anonymous self-administered questionnaire including sociodemographic and occupational variables, as well as attitudes and perceptions regarding arterial puncture. Descriptive statistics and nonparametric tests were performed using R version 3.6.3.

The sample comprised 102 professionals, predominantly female, with a median age of 36 years. Only 5.9% reported routinely using local anesthesia, and 11.8% considered its use necessary. The main reasons for nonuse were the belief that it provided no real benefit and the lack of routine implementation in their unit. Significant associations were observed between clinical unit, previous training, and anesthetic use, with outpatient clinics showing the highest adherence.

The findings reveal a persistent gap between evidence-based recommendations and current practice. These results underscore the need for institutional measures, standardized protocols, and specific training to integrate pain management as an essential component of quality, person-centered care.