title: A randomized clinical trial of dermal anesthesia by iontophoresis for peripheral intravenous catheter placement in children.
abstract: OBJECTIVE
  To assess the efficacy of dermal anesthesia by lidocaine iontophoresis in children undergoing peripheral intravenous (PIV) catheter placement in the emergency department.
  
  
  METHODS
  A double-blind, randomized, clinical trial was conducted at a tertiary children's hospital ED. Alert children 7 years or older requiring nonemergency PIV were eligible. Patients in the lidocaine group received 1 mL of 2% lidocaine with 1:100,000 epinephrine over a potential PIV site by iontophoresis. The control group received 1 mL of.9% saline solution with 1:100,000 epinephrine. After PIV placement, patients ranked the procedural pain using a visual analog scale. Complications were noted by visual inspection or telephone follow-up.
  
  
  RESULTS
  During a 6-month period, 22 patients were assigned to the lidocaine group and 25 to the control group. There was no significant difference in age, sex, or ethnic background between the 2 study groups, and mean application time was 12.0 minutes. The median pain score was.5 in the lidocaine group compared with 4 in the control group (P =.0002; 95% confidence interval [CI] 1 to 5). No significant immediate or delayed complications were observed.
  
  
  CONCLUSIONS
  Lidocaine iontophoresis provides effective dermal anesthesia for children older than 7 years of undergoing nonemergency PIV placement in the ED.
authors: Section of Emergency Medicine, Department of Pediatrics, and the Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA. mkim@mcw.edu
authors: M K
authors: MK
authors: Kim
authors: N M
authors: NM
authors: Kini
authors: T J
authors: TJ
authors: Troshynski
authors: H M
authors: HM
authors: Hennes
mesh_terms: D000772:Anesthesia, Local; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002648:Child; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007478:Iontophoresis / Q000295:instrumentation; D008012:Lidocaine; D008297:Male; D010342:Patient Acceptance of Health Care; D016896:Treatment Outcome
chemical_list: D008012:Lidocaine