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Anaesthesia for arterial puncture in the emergency department: A randomized trial of subcutaneous lidocaine, ethyl chloride or nothing

France, James E.; Beech, Fiona J M; Benger, Jonathan R.; Jakeman, Nicola

Authors

James E. France

Fiona J M Beech

Jonathan R. Benger

Nicola Jakeman



Abstract

Objective To determine whether the use of ethyl chloride and subcutaneous lidocaine are associated with a reduction in pain during arterial blood sampling compared with using no local anaesthesia. Methods Patients over the age of 16 years and who required arterial blood sampling as part of their on-going emergency department management were randomly allocated to one of three groups. Group A received routine skin preparation before arterial puncture (AP); group B received 0.5 ml of 2% lidocaine 2 min before AP; and group C received ethyl chloride immediately before AP. Pain was measured using 100-mm visual analogue scale. Setting Two urban emergency departments. Results Fifty-four patients were recruited. Those receiving lidocaine before AP had lower pain scores [10.2 mm, 95% confidence interval (CI): 4.8-16.3mm] compared with the use of ethyl chloride (23.9 mm, 95% CI: 12.4-35.5mm) and nothing (23.4 mm, 95% CI: 11.7-35.0 mm). Lidocaine was more painful to administer (22.0 mm, 95% CI: 10.9-33.7mm) compared with ethyl chloride (12.9 mm, 95% CI: 5.5-20.3 mm). Conclusion Ethyl chloride is not an effective local anaesthetic agent for AP. When the pain of local anaesthetic administration is taken into account the benefit of subcutaneous lidocaine for single AP is limited. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Citation

Benger, J. R., Beech, F. J. M., France, J. E., & Jakeman, N. (2008). Anaesthesia for arterial puncture in the emergency department: A randomized trial of subcutaneous lidocaine, ethyl chloride or nothing. European Journal of Emergency Medicine, 15(4), 218-220. https://doi.org/10.1097/MEJ.0b013e3282f4d19b

Journal Article Type Article
Publication Date Aug 1, 2008
Journal European Journal of Emergency Medicine
Print ISSN 0969-9546
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 15
Issue 4
Pages 218-220
DOI https://doi.org/10.1097/MEJ.0b013e3282f4d19b
Keywords anaesthesia, arterial puncture, emergency department, ethyl chloride, randomized trial, subcutaneous lidocaine
Public URL https://uwe-repository.worktribe.com/output/1008313
Publisher URL http://dx.doi.org/10.1097/MEJ.0b013e3282f4d19b




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