Rowley,
I always use local for non-emergency cannulation, and it does hurt much
less.
One major misconception about using local for cannulation is that people
give subcutaneous local using an orange needle. In my experience this is as
painful as a blue or pink venflon at least and in many cases takes too long
to work to be useful.
The correct approach is of course to use an insulin syringe to deliver a
tiny bleb of local INTRADERMAL over the site you intend to use. This is
described as a small "nettle sting" by most patients, or not felt at all if
physical/ verbal distraction is used. It works almost instantaneously and
if the vein is superficial and the entry to the vein is quick and easy, no
pain is felt even with large iv cannulae. (You can even do this even before
injecting local more deeply with a larger needle).
All personal experience - this is the technique taught to me by an
anaesthetist as a house office, and has made me a very popular person over
the years with some of the punters. I used to get asked for by name a lot,
especially by chemo patients, because they felt the difference in pain level
was so great. (This did have the downside of increasing my workload
though.)
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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