INITIAL CLINICAL-EXPERIENCE OF A NOVEL DEVICE (THE FRIEND CATHETER) FOR LOCAL-ANESTHETIC DELIVERY AROUND INDWELLING ARTERIAL SHEATHS

The removal of femoral arterial sheaths, particularly after they have been in place for some hours, is a source of pain for patients undergo ing invasive cardiac procedures. Methods of reducing this pain include systemic sedatives, analgesics and local anesthetic. We tested a new disposable plastic device, called the ''Friend'', designed to reduce p ain associated with sheath removal. The ''Friend'' wraps around a stan dard 8 Fr sheath allowing local anesthetic infiltration through side h oles into local tissue. Methods. Seventy-two patients undergoing inter ventional procedures were randomized to 3 groups for anesthetic admini stration just prior to sheath removal. Group 1 (control) received no l ocal anesthetic. Group 2 (local) received 10 mi of lignocaine directly infiltrated with syringe and needle around the sheath. Group 3 (''Fri end'') had the ''Friend'' inserted with the sheath and 10 mi. of ligno caine was delivered via the device. Pain around the sheath was assesse d prior to, during and just after, sheath removal using a 5 point verb al scale. Results. Sixty-two patients completed the study. There were no serious complications related to the 'Friend' device. The Friend gr oup patients had significantly less pain associated with sheath remova l than the control group. (Mean pain difference 1.28 vs. 0.34, p 0.04) . Pain scores in group 2 (local) did not differ significantly from the control group. The additional estimated cost involved in using the Fr iend was $16.93 per patient. Conclusions. The Friend device is a new, inexpensive and safe method of reducing pain associated with removal o f arterial sheaths after cardiac interventional procedures.