Pain and efficacy of local anesthetics for central venous access.
OBJECTIVE
To compare pain during injection and efficacy of analgesia of local anesthetics during central venous line placement.


METHODS
Sixty-two patients were studied in a randomized, double-blinded prospective fashion. Patients received 1% lidocaine (L), buffered 1% lidocaine (LB), or 2% chloroprocaine (CP) injected around the internal jugular vein for procedural analgesia for central venous access. Patients reported pain via a standard linear visual analog scale, with 0 representing no pain and 10 being the worst pain imaginable.


RESULTS
Overall patient perception of pain was better with CP and L than LB with mean scores of CP 2.4, L 2.6, LB 4.2. Pain with injection mean scores were CP 2.1, L 2.5, LB 3.2. Pain with catheter placement scores were CP 2.5, L 1.7, LB 3.4. Operator assessment of overall pain values were CP 1.9, L 2.2, LB 3.4. LB consistently scored the worst, though compared with CP, this only reached statistical significance in overall patient pain and pain at catheter insertion compared with L.


CONCLUSIONS
Though chloroprocaine scored better than lidocaine in 3 of 4 parameters, this trend did not achieve statistical significance. Adding sodium bicarbonate to lidocaine isn't justified in routine practice, nor is routine replacement of lidocaine with chloroprocaine.
Division of Cardiothoracic Anesthesiology, Scott and White Hospital, The Texas A&M University College of Medicine, Temple, TX, USA.
William C
WC
Culp
Mohammed
M
Yousaf
Benjamin
B
Lowry
Timothy C
TC
McCowan
William C
WC
Culp