Comparison of lignocaine spray 10% versus normal saline spray for pain relief during intravenous cannulation in adults

Abstract

Background: Venepuncture, a simple procedure, is associated with pain, anxiety, and discomfort. While the application of coolant has been extensively studied, lignocaine (lidocaine) spray has been sparingly evaluated with variable advantages. Aims and Objectives: This study aimed to compare the efficacy of lidocaine spray versus normal saline spray in reducing venepuncture-related pain. Materials and Methods: Seventy-two patients were randomized to receive either lidocaine spray (Group L, n=36) or normal saline spray (Group C, n=36), five such sprays from a distance of 5 cm, and skin disinfectant was applied after 5 min of spraying. Pain intensity was measured post-procedure using a 0–100 mm Visual Analog Scale (VAS). Results: Patients receiving lidocaine had considerably lower pain levels compared to the control group (mean VAS score 26.5 mm vs. 46.9 mm, respectively). The median scores (in mm) further supported this trend (20 vs. 50, respectively). The use of lidocaine resulted in an average pain reduction of 20.4, which exceeds the threshold for a clinically important difference. Total pain-free status was observed in a considerably higher proportion of patients receiving lidocaine spray over normal saline spray (six [16.7%] vs. one [2.8%] patients, respectively, P<0.001). A considerable proportion of patients receiving lidocaine spray expressed comfort compared with those receiving normal saline spray (97.2% vs. 55.5%, respectively, P˂0.001). Conclusion: Lidocaine spray appears to be an effective and non-invasive method for reducing venepuncture-associated pain. Given the considerable clinical impact and ease of use, lidocaine spray can be used to improve patient comfort during needle-stick procedures.