ADMINISTRATION OF LOCAL ANAESTHETIC BEFORE INTRAVENOUS CANNULATION REDUCES CANNULATION PAIN IN THE EMERGENCY DEPARTMENT.

Introduction: Local anaesthetic to relieve the pain of intravenous cannulation is widely used in paediatric and some anaesthetic practice. The application and the usage in patients presenting to emergency department is scarce. Aim: To study the applicability of local anaesthetic before inserting intravenous cannula in patients presenting to the emergency department. Methodology: This is a double blinded placebo controlled randomized study conducted on patients presenting to the emergency department. Total sample size was 450 and was divided into three equal groups? viz. Group A / study group (infiltration with local anaesthetic, Lignocaine 1% 0.5 ml using 27 gauge needle and insulin syringe.), Group B/ control I Group (infiltration with normal saline 0.5 ml using 27 gauge needle and insulin syringe.) and Group C/ control II Group (no infiltration). The hemodynamic changes pre and post cannulation and verbal pain rating scores were recorded by blind observers in all groups. Results: The post cannulation heart rates of the study group (91.77 ? 24.66) control II (98.03 ? 23.18) and control I (96.81 ? 21.87) groups differed significantly with P value 0.0485 (< 0.05). Pain scores in control-I and control-II groups do not vary significantly with P value 0.111. Post cannulation pain is having significant positive correlation with Increase in Heart rate (r = 0.671, P value < 2.2e-16) and also Increase in Diastolic Blood Pressure (r = 0.476, P value < 2.2e-16). Post cannulation pain was having significant positive correlation with increase in Heart rate (r = 0.671, P value < 2.2e-16) and also increased diastolic blood pressure (r = 0.476, P value < 2.2e-16). Conclusion: Intravenous cannulation can be made pain free with patient satisfaction and hemodynamic stability if carried out with prior local anaesthetic infiltration.