As one of the most common invasive nursing procedures,1 insertion of an intravenous catheter has a long track record of being painful, stressful,2 and a patient dissatisfier.3 In an effort to promote comfort during intravenous cannulation, nurses may use local anesthetics to infiltrate the skin surrounding insertion sites. Such infiltrations, however, are known to cause painful stinging sensations, most likely due to the acidity of the solution. Thus, the purpose of this clinical review is to describe the current evidence related to the following question: Do different local anesthetic agents vary in their effectiveness in reducing the pain associated with intradermal infiltrations, or with insertion of an intravenous catheter and advancement of the cannula?

The search strategy included MEDLINE, CINAHL, Cochrane, and DARE databases. Key words included intravenous insertion, lidocaine, normal saline, and pain. All...

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