Discussion
itching, anxiety, pain
ADVERSE REACTIONS
To our knowledge, this is the first study on the analgesic effect of lidocaine spray on non-coring needle puncture. We found that lidocaine spray was effective in relieving pain due to TIVAP puncture in patients, with high patient acceptance and low incidence of adverse reactions. In addition, although the median comfortability score of patients in the intervention group was the same as that of the control group, but there was a significant difference in comparison between the two groups; the successful puncture rate of the first time puncture was 100% as in the control group.Compared to conventionally used injection needles, non-coring needles contain a folding point and have a slightly longer bevel with a smaller angle, which puncture at a 90-degree angle to the injection seat with only a portion of the force acting on the needle tip, making the needle slower to pass through the skin and easily causing pain to the patient. Our results showed that the pain score of patients in the lidocaine spray intervention group was 21.38 mm lower than that in the control group, and the proportion of patients with moderate and severe pain was significantly lower than that of the control group, indicating that lidocaine spray can effectively reduce the pain caused by the non-coring needle puncture of patients implanted with TIVAP. Our results were inconsistent with the findings of Joris Datema [Notably, 23.8% of the patients in the intervention group still felt mild pain during non-coring needle puncture, indicating that the lidocaine spray could not completely eliminate the pain caused by the non-coring needle puncture of the patients with TIVAP. Previous studies pointed out that lidocaine spray was not enough to eliminate the pain related to venous puncture [Although the median score of comfortability for both groups of patients was 10, the difference in the comfortability score between the two groups was statistically significant. The local anesthetic effect of lidocaine spray on the skin might reduce the stimulation to the patient’s skin during disinfection and alleviate the pain of non-coring needle puncture, thus relieving anxiety and improving the comfortability of the patient. In terms of acceptance, 78.6% of patients in the intervention group reported that they were willing to choose this spray to reduce intubation pain in the future, while the acceptance in the control group was only about 28.6%, reflecting the patient satisfaction with lidocaine spray. Firstly, patients can directly benefit from lidocaine spray, that is, reducing the pain during needle puncture. Secondly, lidocaine spray can produce a mellow aroma when sprayed out. In addition, one significant advantage of lidocaine spray in pain management related to non-coring needle puncture is that it can reduce the pain of non-coring needle puncture and has no need for injection. Moreover, the effect of alleviating pain can be achieved within 5 min after the application of lidocaine spray, while local anesthetic cream and gel usually require a waiting period of at least 30 min. Hence, the use of the spray can save a lot of waiting time for patients and medical staff.In this study, only one patient in the intervention group complained of slight itching on the skin at the puncture site after the non-coring needle puncture, but it was quickly relieved. There were no other adverse reactions during the 1 week of follow-up. Many factors lead to skin itching, and it is difficult to determine whether the itching is caused by lidocaine spray. It is reported that 27.6% of patients have white skin 5 min after non-coring needle puncture with lidocaine cream for local anesthesia [