Buffered lidocaine's effect on procedure complications, pain, movement, site outcome, and satisfaction with sheath removal in interventional cardiology patients

Abstract

Arterial and venous sheath removal is primarily performed by trained registered nurses in interventional cardiology units across the United States. A standard of care for pain management for this procedure has not been developed. Buffered lidocaine is infiltrated into the tissues in the cath lab prior to sheath insertion; however, many nursing units do not use this method of analgesia with the removal of sheaths. The purpose of this study was to determine the effects of buffered lidocaine on procedural complications, pain, movement, site outcome, and patient satisfaction.

Interventional cardiology patients were randomized by an investigational pharmacist into one of four groups: buffered lidocaine injection, lidocaine injection, saline injection, or no injection. The injections were blinded to the researcher and research associates by the investigational pharmacist. The subcutaneous injections were performed by research associates who pulled the arterial sheaths. Patients were observed for procedural complications, level of pain, movement, site complications, and questioned on level of satisfaction. Intravenous analgesics received with the procedure were recorded as potential covariates. Data analysis was achieved with multiple analyses of variance. No significant difference was found between the four groups in procedure complications, pain, site complications, movement, and satisfaction.