Assessing patient comfort: local infiltration of lidocaine during femoral sheath removal

BACKGROUND: Patient comfort is a primary nursing concern when removing femoral sheaths. The use of lidocaine infiltration, a common practice at our facility, was not addressed in the reviewed literature. OBJECTIVE: To assess and evaluate the level of patient comfort and efficacy of lidocaine hydrochloride as a local anesthetic during femoral sheath removal and application of a compression device. METHODS: A literature search and telephone interviews were conducted with nurses and technicians who removed or assisted with the removal of femoral sheaths in 13 hospitals in the United States. Three patient comfort indicators were then developed and used for data collection. Over a 12-month period, nurses in the cardiology interventional unit removed the femoral sheaths without the use of lidocaine from 111 angioplasty/arthrectomy patients and evaluated the level of patient comfort. RESULTS: A literature search provided no information that supported the use of lidocaine hydrochloride infiltration during sheath removal. Telephone interviews showed that six of the hospitals used lidocaine as standard procedure and seven did not use lidocaine at all. Of the evaluated patients, 105 (94.59%) reported comfort during sheath removal without local infiltration of lidocaine. CONCLUSION: Our results supported the premise that patients do not require lidocaine before sheath removal to maintain an acceptable level of comfort.