Radial artery blood gas sampling: A randomised controlled trial of lidocaine local anaesthesia

Ryckie G. Wade, Jim Crawfurd, Donna Wade, Richard Holland

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14 Citations (Scopus)
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Introduction: Radial artery puncture is a common procedure and yet the role of local anaesthesia for reducing the pain of this procedure continues to be debated. Clinical practice is variable and there is potential for substantial financial savings. This is the first randomised trial to investigate the effectiveness of subcutaneously injected lidocaine anaesthesia on the perceived pain of radial artery puncture and the financial impact.
Methods: Between December 2012 and April 2013, 43 patients in the Emergency Department were randomised into the intervention group to receive lidocaine 1% 1ml subcutaneously or the control group (to receive no local anaesthesia) prior to radial artery puncture for blood gas sampling. Pain was rated on a 10cm visual analogue scale (VAS) and procedural variables collected for between group analyses.
Results: Overall, 41 participants were included. Subcutaneously injected lidocaine anaesthesia did not reduce the median pain of radial artery puncture (control 1.8 vs. intervention 1.6 cm, p=0.938). Those patients who had other systemically acting analgesia appeared to report reduced pain for radial artery puncture (0.60 vs. 2.30 cm, p=0.105) as did those where a smaller 25-gauge needle was used compared to the standard 22-gauge reported (1.40 vs. 4.35 cm, p=0.150), although these were not statistically significant. Anxious patients and those requesting local anaesthesia experienced relatively higher levels of pain.
Conclusion: Local anaesthesia did not reduce the perceived pain of radial artery puncture.
Original languageEnglish
Pages (from-to)185-191
Number of pages6
JournalJournal of Evidence-Based Medicine
Issue number4
Publication statusPublished - 15 Nov 2015


  • Pain
  • success
  • outcome
  • local
  • injected
  • subcutaneous
  • anaesthesia
  • anaesthetic
  • lidocaine
  • radial
  • artery
  • arterial
  • blood
  • gas
  • randomised
  • clinical
  • controlled
  • control
  • trial
  • needle

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