Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
---|---|---|---|---|---|
Harrison N et al, 1991, UK | 60 patients for surgery. Cannulation with 18G or 20G or 22G venflon on one arm v injection with 1% sub-cut lignocaine with a 25G needle on other arm. | Clinical trial. Randomized. Blinded. | Pain using visual analogue scales. | Cannulation significantly more painful than lignocaine injection in all groups. | Some patients were pre-medicated |
Langham BT et al, 1992, UK | 60 patients for surgery. Double cannulation with 18G, 20G or 22G venflons preceded by an injection of 1% sub-cut lignocaine with 25G needle on one arm v nothing on the other. | Clinical trial. Randomized. Blinded. | Pain using visual analogue scales. | Cannulation without lignocaine significantly more painful than cannulation with lignocaine | Some patients were pre-medicated |
Nuttall GA et al, 1993, USA | 280 patients for surgery. Cannulation with 18G venflon preceded by nothing v injection with 25G needle of 0.9% benzyl alcohol or 3% 2-chloroprocaine or 1% lignocaine or 1% lignocaine with preservative or 1% alkalinized lignocaine with preservative or normal saline. | Clinical trial. Randomized. Double-blinded. Controlled. | Pain using visual analogue scales. | Cannulation without anaesthetic significantly more painful than cannulation withanaesthetic.Alkalinized lignocaine had the lowest mean pain score for cannulation. | |
Selby IR et al, 1995, UK | 160 patients for surgery. Cannulation with 20G venflon preceded by nothing v cannulation preceded by EMLA or ethyl chloride spray or 1% sub-cut lignocaine injected with 25G needle. | Clinical trial. Randomised. | Pain on anaesthetic application, cannulation and a minute afterwards using visual analogue scales. | Cannulation without lignocaine significantly more painful than lignocaine injection. | Not blinded Did not compare pain of whole procedure |
Number of failed cannulations | No significant difference in number of failed cannulations. | ||||
Van den Berg AA et al, 1995, USA | 278 patients for surgery. Cannulation with 21G butterfly or 23G butterfly or 20G venflon v injection with 1% sub-cut lignocaine with 25G needle prior to cannulation with a venflon of any size. | Clinical trial. Randomized. Blinded. | Pain. Subjectively using observation and objectively using visual analogue scales. | Cannulation with 20G venflon and 21G butterfly significantly more painful than cannulation with 23G butterfly and anaesthetic injection prior to cannulation. | Single-blinded |
Klein EJ et al, 1995, USA | 59 children requiring cannulation in emergency dept. Cannulation with 18-24G venflons preceded by nothing v cannulation preceded by injection with 27G needle of sub-cut buffered lignocaine. | Clinical trial. Randomized. | Pain of entire procedure using visual analogue scales. | Cannulation without lignocaine significantly more painful than cannulation with lignocaine regardless of venflon size. | Not blinded Small sample size with wide confidence intervals |
Number of attempts preceding successful cannulation. | No significant difference in number of attempts. | ||||
Sacchetti AD et al, 1996, USA | 110 children under 2 years requiring cannulation in Emergency Dept.. Cannulation with 24G venflon preceded by nothing v cannulation preceded by injection with 27-29G needle of sub-cut lignocaine. | Clinical trial | Number of attempts preceding successful cannulation. | No significant difference between groups. | 2 groups entered into study over 2 different periods Not blinded Not randomized. |
Burgher SW et al, 1998 UK | 103 patients requiring cannulation in Emergency Dept.. Cannulation with 18G venflon preceded by nothing v cannulation preceded by injection with 27g needle of sub-cut buffered lignocaine or sub-cut 0.9% benzyl alcohol and normal saline. | Clinical trial. Randomized. Blinded. | Pain of anaesthetic injection and cannulation using visual analogue scales. | Cannulation without lignocaine significantly more painful than lignocaine injection and significantly more painful than cannulation with lignocaine. | Patients entered into study when investigators available and department not too busy Did not compare pain of whole procedure |
Number of attempts prior to successful cannulation and number of successful cannulations on the first attempt. | No significant difference in number of attempts or success rate. | ||||
Fein JA et al, 1998, USA | 99 children requiring cannulation in Emergency Dept. Cannulation with 18-24G venflons preceded by nothing v cannulation preceded by injection with 27G needle of sub-cut lignocaine or benzyl alcohol and normal saline. | Clinical trial. Randomized. | Pain using visual analogue scales. | Cannulation without lignocaine significantly more painful than cannulation with lignocaine regardless of venflon size | Patients entered into study when investigators available |
Holdgate A et al, 1999, Australia | 166 patients requiring cannulation in Emergency Dept. Cannulation preceded by nothing v cannulation preceded by injection with 25G needle of sub-cut 1% lignocaine. | Clinical trial. Randomized | Successful cannulation at first attempt. | No significant difference between groups. | Not blinded Venflon size not considered |