SALINE WITH BENZYL ALCOHOL AS INTRADERMAL ANESTHESIA FOR INTRAVENOUS LINE PLACEMENT IN CHILDREN

Background: It has been suggested that saline with benzyl alcohol pres ervative has anesthetic properties when injected intradermally, We com pared the pain associated with intravenous line (i.v.) placement in pa tients who received intrader mal lidocaine, intradermal saline + benzy l alcohol preservative, or no anesthesia, Methods: We performed a pros pective randomized clinical trial in a convenience sample of children over 6.8 years old seen in the emergency department of a large, urban children's hospital. Children received either intradermal saline with 0.9% benzyl alcohol preservative, intradermal lidocaine, or no anesthe sia prior to i.v. placement, The patient recorded the pain of the enti re procedure on a visual analog scale. In the two groups that received an intradermal injection, the patient also recorded the pain of the f irst and second injection on a similar scale. Results: Ninety-nine chi ldren were studied, 33 in each group. Pain scores were not normally di stributed, The median pain scores in millimeters for the entire proced ure were 41.0 (in terquartile range, 11 to 62) in the nonanesthetic gr oup, 9.0 (interquartile range 3 to 37) in the saline with benzyl alcoh ol group,and 10.0 (interquartile range, 4 to 32) in the lidocaine grou p (P = 0.006 for saline vs nonanesthetic, P = 0.04 for lidocaine vs no nanesthetic, P = 0.57 for saline vs lidocaine), There was no differenc e between groups with regard to baseline anxiety, demographic characte ristics, size of i.v. inserted, number of i.v. attempts, or pain upon intradermal injection. Conclusion: Saline with benzyl alcohol and 1% l idocaine are equally effective as intradermal anesthetics for i.v. lin e placement in children, and are both more effective than no anesthesi a.