Randomized Controlled Trial to Compare Effects of Pain Relief During IV Insertion Using Bacteriostatic Normal Saline and 1% Buffered Lidocaine

A major nursing responsibility is to provide patient care and comfort. Pain reduction is a component of this responsibility to include preanalgesia for peripheral intravenous (IV) insertion. This double-blind randomized controlled trial compared differences in the pain level experienced by 56 nurses during IV cannulation in each arm; one premedicated with bacteriostatic normal saline (BNS) and another with 1% buffered lidocaine (Lido). Subjects and IV inserters were blinded to the type of preanalgesia administered during each cannulation. Subjects rated pain after each cannulation using a 0 to 10 verbal descriptor scale. After IV cannulation was completed in both arms, subjects were asked to reflect on which arm, and thus which type of preanalgesia, would be preferred if an IV is needed in the future. Sample demographics reflected mean years as registered nurse: 18.6 ± 10.6 years; mean years in direct care: 7.5 ± 4.7 years; and mean years experience in inserting IVs: 5.2 ± 4.4 years. Significant differences were detected between overall BNS and Lido pain scores (2.36 ± 1.45 vs 0.93 ± 1.3; P < 0.05). Although blinded to the type of preanalgesia used, 89% of subjects chose the arm premedicated with Lido. Although statistical differences in perceived pain were detected, the pain scores were low and may not be clinically significant.