Arterial blood gas: local anaesthetic reduced pain.

Clinical bottom line (level 1b)

  1. Patients who had local anaesthetic before arterial blood gas sampling felt less pain than those given placebo.
  2. The local anaesthetic injection was not clearly more painful than injecting saline.
Lightowler and Elliott: Journal of the Royal College of Physicians 1997; 31: 645-646
Expires November 2002

The study

Double-blinded concealed randomised trial with intention-to-treat
Setting: acute hospital, UK

66 patients (aged ?, ?% male) requiring arterial puncture
Control Group: (n = 33, 33 analysed): placebo
Experimental Group: (n = 33, 33 analysed): 0.5 ml of 2% lidocaine , followed by arterial puncture after two minutes

100% followed for ?

The evidence

Outcome Control Group
(SD)		 Experimental Group
(SD)		 Mean Difference
(95% CI)
pain from local anaesthetic injection (scale 0-5) 2.00
(0.80) 		1.80
(0.80) 		0.2
(0.0 to 0.6)
pain from arterial stab (scale 0-5) 2.20
(0.90) 		1.50
(0.80) 		0.7
(0.3 to 1.1)
difficulty of procedure (rated by doctor: scale 0-5) 1.20
(0.50) 		1.10
(0.40) 		0.1
(0.0 to 0.3)

Comments

  1. Practically, I would like to know the patient's preference , then I decide whether local anaesthetic infiltration should be used.

Citation

  1. Lightowler JV, and Elliott MW: Local anaesthetic infiltration prior to arterial puncture for blood gas analysis: a survey of current practice and a randomised double-blind placebo-controlled trial. Journal of the Royal College of Physicians 1997; 31 (.): 645-646
Contributor: Chris Ball and Clare Wotton, November 2000
Reviewer: Mitsuhiro Kamei

Clinical Question.
Patient undergoing lung function tests
Intervention or Exposure local anaesthetic before arterial blood gas sampling
Outcome pain