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local anesthetics for PIV placment

I am looking for information of research concerning creams, sprays vs. intradermal lidocaine for piv starts. Our hospital wants it to be a standard to use or offer some form of anesthetic for all IV's but want to use just one item. I just can't see sticking someone with lidocaine so I can stick them with an angiocath. There has got to be a better and more cost effective way. Any info would be appreciated.
P.Roberts PICC RN

Vivienne Ganter-Ritz
use of intradermal anesthesia for IV placement

Many studies had been taken place that validate the effectiveness of intradermal analgesia for IV access. The most common analgesia is 1% lidocaine or bacteriostatic Normal Saline that has benzyl alcohol as a perservative. Refer to Comparison of BNS and Lidocaine used as Intradermal anesthesia found in the Journal of PeriAnesthsia Nursing Vol 21 August 2006

Wendy Erickson RN
I wonder if you have ever had

I wonder if you have ever had an 18 g peripheral IV inserted with and without lidocaine.  There is absolutely no doubt in my mind (from extensive personal experience) that the lidocaine makes a HUGE difference in comfort and there is no comparison between the size of the tiny lidocaine needle versus the big honker of an 18 ga.  Give me intradermal lidocaine anytime, every time!

Wendy Erickson RN
Eau Claire WI

Gwen Irwin
local anesthetics for PIV placment

I probably haven't had as many experiences, but the ones that I have had also indicate the preference for lidocaine before the IV stick.  Many nurses are reluctant to stick the patieint 2 times, but what they don't realize is that the 2nd one is NOT FELT.  Ask your patients.

Gwen Irwin

Austin, Texas

Go to my blog

Go to my blog to read more about local anesthesia. 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

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