Should pain relief be given for insertion of a peripheral intravenous catheter?

Yes. Bond et al's (2016) systematic review concluded that the pain of applying any local anaesthetic is less than that of unattenuated cannulation. Pain relief should be standard practice.

Are vapocoolant sprays effective for reducing pain associated with PIVC insertion?

Yes. Griffith et al's (2016) Cochrane systematic review and meta-analysis pooled the results from 8 clinical trials involving 848 participants that investigated the use of vapocoolant sprays or "cold sprays" to reduce pain on the insertion of the IV catheter. Moderate-quality evidence indicates that use of a vapocoolant immediately before intravenous cannulation reduces pain during the procedure. Use of vapocoolant does not increase the difficulty of cannulation nor cause serious adverse effects but is associated with mild discomfort during application



Bond M, Crathorne L, Peters J, Coelho H, Haasova M, Cooper C, Milner Q, Shawyer V, Hyde C, Powell R. (2016) First do no harm: pain relief for the peripheral venous cannulation of adults, a systematic review and network meta-analysis. BMC Anesthesiology, 16, 1 DOI: 10.1186/s12871-016-0252-8

Ref: Griffith RJ, Jordan V, Herd D, Dalziel SR. Vapocoolants (cold spray) for pain treatment during intravenous cannulation. Cochrane Database Systematic Reviews 2016 Issue 4. Art. No.CD009484.doi:10.1002/14651858.CD009484.pub2

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