Brief Focal Ultrasound With Topical Anesthetic Decreases the Pain of Intravenous Placement in Children

OBJECTIVE:To determine whether brief, focal pretreatment of children's skin with low-frequency ultrasound followed by a 5-minute application of a 4% lidocaine topical anesthetic decreases the pain of intravenous (IV) catheter placement. METHODS:A randomized, double-blind, placebo-controlled tri...

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Bibliographic Details
Published in:	Pediatric emergency care Vol. 22; no. 5; pp. 339 - 345
Main Authors:	Skarbek-Borowska, Sara, Becker, Bruce M, Lovgren, Kirsten, Bates, Adriana, Minugh, P. Allison
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-05-2006 Lippincott Williams & Wilkins
Subjects:	Administration, Topical Adolescent Analgesics Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthetics, Local - administration & dosage Attitude of Health Personnel Biological and medical sciences Catheterization, Peripheral - adverse effects Child Combined Modality Therapy - methods Double-Blind Method Emergency Nursing - methods Erythema - etiology Forensic medicine Humans Infusions, Intravenous Intensive care medicine Lidocaine - administration & dosage Medical sciences Neuropharmacology Pain - diagnosis Pain - etiology Pain Management Pain Measurement Patient Satisfaction Pediatrics - methods Pharmacology. Drug treatments Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Treatment Outcome Ultrasonic Therapy - adverse effects Ultrasonic Therapy - instrumentation Ultrasonic Therapy - methods Human Intensive care Intravenous administration SonoPrep Catheter intravenous catheter sonophoresis Local administration Pain Anesthetic Child Ultrasound Resuscitation LMX4
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Summary:	OBJECTIVE:To determine whether brief, focal pretreatment of children's skin with low-frequency ultrasound followed by a 5-minute application of a 4% lidocaine topical anesthetic decreases the pain of intravenous (IV) catheter placement. METHODS:A randomized, double-blind, placebo-controlled trial enrolling children 8 to 18 years of age undergoing IV placement as part of their care in a pediatric emergency department. Thirty-eight children received pretreatment followed by 5-minute application of a topical anesthetic. Thirty-nine children received pretreatment followed by 5-minute application of a placebo cream. Children and parents rated the pain associated with IV placement using the visual analog scale (VAS). RESULTS:There were no significant differences in demographics between the 2 groups. Children in the treatment group had significantly lower VAS scores (mean, 2.29) than children in the control group (mean, 3.23) (P = 0.023; 95% confidence interval of the mean difference, −1.87 to −0.02). The parents' VAS scores of the child's pain were also lower for the treatment group (mean, 2.47 vs 3.39; P = 0.038; confidence interval, −1.97 to 0.11). CONCLUSIONS:Visual analog scale scores measuring children's pain and parents' perception of the child's pain were lower in those who were pretreated with brief focal ultrasound and 5 minutes of 4% lidocaine cream when compared with those pretreated with ultrasound and placebo.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0749-5161 1535-1815
DOI:	10.1097/01.pec.0000216566.33747.5b