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Safety, tolerability, and efficacy of iontophoresis with lidocaine for dermal anesthesia in ED pediatric patients.

Abstract：

INTRODUCTION:This study examined the safety, tolerability, and efficacy of iontophoresis with 30 mA of lidocaine for dermal anesthesia in children younger than 84 months in the emergency department and the usefulness of a modified version of the Pre-verbal, Early Verbal Pediatric Pain Scale (M-PEPPS). METHODS:Three expert nurses completed the protocol for iontophoresis and inserted an intravenous catheter. Parents scored pain by using the 10-cm visual analogue scale, nurses used the M-PEPPS, and children, if able, self-reported pain during the procedure and at needle stick. RESULTS:Serum lidocaine levels were within the normal laboratory reference range. Adverse effects were minor and disappeared prior to discharge from the emergency department. Eighty-five percent of the children had M-PEPPS scores < or=6 during the iontophoresis procedure; 42% had scores of < or =6 at needle stick. Eighty-two percent of the parents marked the vas as < or =30 during the procedure; 65% indicated scores of < or =30 at needle stick. Four children self-reported "a lot of pain" at needle stick. Although low to moderate, M-PEPPS scores and parental pain ratings were significantly correlated at both points in time. DISCUSSION:Iontophoresis with lidocaine is safe for use in young children. It does not create any long-term untoward effects and is quite well tolerated. It is not clear if the higher pain scores at needle stick reflect anxiety and fear of a needle or a painful experience.

journal_name

J Emerg Nurs

journal_title

Journal of emergency nursing

authors

Schultz AA,Strout TD,Jordan P,Worthing B

doi

10.1067/men.2002.125791

keywords:

subject

Has Abstract

pub_date

2002-08-01 00:00:00

pages

289-96

issue

4

eissn

0099-1767

issn

1527-2966

pii

S009917670200003X

journal_volume

28

pub_type

杂志文章

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