The_Use_of_Anesthetics_for_IV_Starts Columbus State University 教学教案.ppt

The Use of Anesthetics for IV Starts Columbus State University Purpose Patient advocates: - Strive to provide the utmost comfort for patients Purpose: - To determine if the use of local anesthetics reduces the pain and discomfort of patients during venous catheterization Clinical Question Should hospital patients receive local anesthetics prior to intravenous catheterization rather than no local anesthetics as a measure to reduce pain? Options No Anesthetics Cream Lidocaine EMLA ELA-Max No Local Anesthetics It is the patient’s option to choose whether they would like to have local anesthetics EMLA Cream Patients taking drugs that induce the production of methemoglobin (such as Sulfonamides, Acetaminophen, and Phenobarbital) should be aware that it can cause methemoglobinemia It is also contraindicated for patients allergic to Lidocaine, Prilocaine, or other topical anesthetics ELA-Max Each gram of ELA-Max contains 40 mg of Lidocaine, lecithin, propylene glycol, carbomer 940, benzyl alcohol, vitamin E acetate, cholesterol, triethanolalmine, polysorbate 80, and purified water Reaches maximum effect in 30 minutes It does not contain Prilocaine so there is no risk of methemoglobinemia ELA-Max applied for 30 minutes is as effective as EMLA cream applied for 60 minutes in preventing pain during IV insertion Cost of ELA-Max and EMLA Cream is approximately the same Kleiber. Topical Anesthetics for Intravenous Insertion in Children: A Randomized Equivalency Study. October 2002. Lidocaine Recommended dose is 0.1-0.5 mL of 1% Lidocaine Using a 25-29 gauge needle, inject the Lidocaine into the intra-dermal tissue lateral and distal to the intended IV insertion site to prevent fluid from obscuring the IV site Onset is rapid and IV can be inserted in 30 seconds A downside is that it causes pain Lidocaine The pain of the Lidocaine injection is significantly less than the reported pain of the IV insertion without Lidocaine When given the option for use of Lidocaine