1% lidocaine injection, EMLA cream, or "numby stuff" for topical analgesia associated with peripheral intravenous cannulation.

The purpose of this study was to assess patient's perception of pain associated with peripheral intravenous (i.v.) cannulation, using 3 methods of applying local anesthetics. A prospective, randomized, quasi-experimental study was conducted, using a convenience sample of men and women, ASA physical status I, II, or III, undergoing outpatient or same-day surgery. Group 1 received a subcutaneous injection of 1% lidocaine, group 2 received topical EMLA cream for 45 to 60 minutes, and group 3 received treatment with "Numby Stuff" for 40 mA minutes. After the intended analgesic treatment was complete, the patient was asked to rate the pain experienced during the skin-numbing process. An i.v. was then started using an 18-gauge i.v. catheter, and the patient again was asked to rate the amount of pain experienced with the catheter insertion. A visual analog scale was used as the tool of measurement for pain. Results of the study showed that group 1 experienced a higher treatment pain score than either group 2 or group 3, while group 2 experienced a higher pain score when the i.v. was started than either group 1 or group 3. Of the 3 methods tested, results seem to indicate that the Numby Stuff system using iontophoresis is the superior method for decreasing the pain associated with peripheral i.v. cannulation, and application of the analgesic method does not cause significant pain.