Bacteriostatic Normal Saline Compared With Buffered 1% Lidocaine When Injected Intradermally as a Local Anesthetic to Reduce Pain During Intravenous Catheter Insertion

Pain associated with intravenous (IV) catheter insertion commonly causes fear and anxiety in presurgical patients. To reduce pain, a common procedure is intradermal injection of a local anesthesia. The aim of this study was to determine whether there is a significant difference in a patient's pain level after intradermal injection and IV catheter insertion when comparing intradermally injected bacteriostatic normal saline with 0.9% benzyl alcohol (a preservative added with an anesthetic component) with buffered 1% lidocaine to numb the IV line site. Using a double-blinded experimental design, 376 patients were randomly assigned to a bacteriostatic normal saline group or buffered 1% lidocaine group. Patients were given two needle sticks but rated only one pain score of either post-intradermal or post-IV injection using a 10-point numeric rating scale. A statistically significant difference was found in the IV pain scores, with subjects who received buffered 1% lidocaine reporting less pain than those who received bacteriostatic normal saline (P = .025). However, no significant difference was found in the intradermal pain scores (P = .792). Females reported higher IV pain scores than males only in the buffered 1% lidocaine group (P = .001). No statistically significant differences were found between the two anesthetics with intradermal and IV pain scores for IV placement side, site, IV within 30 days, needle gauge, previous IV experience or problems, vein visibility, or study nurse. This study determined that buffered 1% lidocaine was more effective than bacteriostatic normal saline in reducing pain during IV catheter insertion.