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lidocaine for port access

Lidocaine intradermal injections prior to port access have been referred to several times on this forum.  I just reviewed the new INS EBP book (2009) and there is no mention of this practice in the section on port access.  For those who do this, can you tell me how the practice was initiated?  Who was most interested in doing this?  Was there evidence to support it?  It seems to me there are differences between using this practice for peripheral IV starts vs. port access. 


I rarely use lidocaine, and only if the port is deep and the patient requests it. I do have a concern/question about the use of subq lidocaine. We have a number of ports that are not only very close to the surface, but stick right out. Some of these are on older clients with chronic diseases. I am concerned that with repeated subq injections in that thin layer of tissue over the port we could contribute to breakdown of the skin and possible erosions over the port. Am I being too cautious? We have found alternatives for anyone who wants numbing. I work outpatient infusions, so some put emla cream on at home, with some we put a little ice pack on before I start the access proedure, and a couple just have me access without numbing.

Does anyone have any data or thoughts on repeated subq injections and skin erosions over the port?


Gail McCarter,RN

Franklin nfusion Therapy

Franklin NH


Gail McCarter, BSN,CRNI

Franklin, NH

I have never seen any

I have never seen any published data on the incidence of skin erosion, but I do know that it happens. I think you could add scar tissue development over the port with these injections as well, making it more difficult to access. I would prefer your ideas of topical creams or ice. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Thanks for posting a reply to

Thanks for posting a reply to this issue--been waiting a long time for one.  An ASPMN nurse that I was having an email conversation with about this issue also posted the same question on the APS-Nurse SIG listserve.  No one answered, just as I have had minimal response.  I know there was mention of using lidocaine subq during port access previously on this listserve.  If you do, I'd sure like to hear from you about it.  Thanks.

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