title: Do we necessarily need local anaesthetics for venous cannulation? A comparison of different cannula sizes.
abstract: OBJECTIVE
  This randomized, prospective study was performed to evaluate the efficacy of a subcutaneous local anaesthetic infiltration prior to venepuncture using different cannula sizes.
  
  
  METHODS
  Three-hundred-and-one patients were included in the study, 150 received mepivacaine 1% (0.25 mL) subcutaneously, 151 were cannulated without local analgesia. Patients were further allocated to one of five cannula size groups (standard wire gauge (G)): 20-, 18-, 17-, 16- and 14-G. They were asked to quantify the pain experienced using a four-point rating scale.
  
  
  RESULTS
  In the group without local anaesthetics, 28.8% complained about pain compared to 12% receiving local analgesia. The incidence of pain for 14-G (10%) and 16-G (12.9%) cannulae was significantly reduced in the local analgesia group (P < 0.01) compared to no local analgesia (77.4% and 45.1%). Other cannula sizes showed no difference in pain whether using local analgesia or not.
  
  
  CONCLUSIONS
  Patients profit from a subcutaneous infiltration with mepivacaine 1% prior to intravenous cathetherization only when cannulae of size > or = 16-G are inserted.
authors.affiliation: Klinikum Ludwigshafen, Department of Anaesthesiology, Ludwigshafen, Germany. k.d.roehm@t-online.de
authors.forename: K D
authors.initials: KD
authors.lastname: Röhm
authors.forename: T A H
authors.initials: TA
authors.lastname: Schöllhorn
authors.forename: M J
authors.initials: MJ
authors.lastname: Gwosdek
authors.forename: S N
authors.initials: SN
authors.lastname: Piper
authors.forename: W H
authors.initials: WH
authors.lastname: Maleck
authors.forename: J
authors.initials: J
authors.lastname: Boldt
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D018962:Phlebotomy; D011446:Prospective Studies
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine