This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Rose, J. B. Articles by Chiavacci, R. M. Search for Related Content PubMed PubMed Citation Articles by Rose, J. B. Articles by Chiavacci, R. M. Related Collections Pediatrics Pain

---

PEDIATRIC ANESTHESIA

A Study of Lidocaine Iontophoresis for Pediatric Venipuncture

Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, University of Pennsylvania, School of Medicine, Philadelphia

Address correspondence and reprint requests to John B. Rose, MD, Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, 34th St. and Civic Center Blvd., Philadelphia, PA 19104. Address e-mail to rose{at}email.chop.edu

In this randomized, double-blinded, placebo-controlled study, we evaluated the safety and efficacy of lidocaine iontophoresis for the prevention of pain associated with venipuncture in 59 children aged 6–17 yr. Children received either lidocaine HCl 2% with epinephrine 1:100,000 (Active) or the same formulation without lidocaine (Placebo) via a 20 mA/min iontophoretic treatment. Pain during venipuncture was assessed by the subject, parent, and nurse using a 100-mm visual analog scale. Median (interquartile range) visual analog scale scores were significantly lower in the Active versus Placebo groups: subject, 7.0 (2.0–20.8) versus 31.0 (12.0–48.0), P < 0.001; nurse, 5.0 (2.2–10.8) versus 24.0 (9.0–47.0), P < 0.001; and parent, 3.0 (0.8–7.2) versus 20.0 (4.5–43.0), P < 0.002, respectively. Similarly, higher median satisfaction scores were given to the Active versus Placebo group by the three evaluators. Of the 59 subjects completing the study, 10 subjects experienced a total of 12 adverse events that were all graded as mild. In conclusion, lidocaine iontophoresis is safe in children, reduces discomfort associated with venipuncture, and increases satisfaction when compared with the placebo.

IMPLICATIONS: In this randomized, double-blinded, placebo-controlled study, we found that dermal anesthesia with lidocaine HCl 2% combined with epinephrine 1:100,000 administered via iontophoresis in children is achieved in 8.8 ± 2.1 min, reduces discomfort associated with venipuncture, is safe, and increases satisfaction when compared with the placebo.

This article has been cited by other articles:

				W. T. Zempsky Pharmacologic Approaches for Reducing Venous Access Pain in Children Pediatrics, November 1, 2008; 122(Supplement_3): S140 - S153. [Abstract] [Full Text] [PDF]

				W. T. Zempsky, J. Bean-Lijewski, R. E. Kauffman, J. L. Koh, S. V. Malviya, J. B. Rose, P. T. Richards, and D. J. Gennevois Needle-Free Powder Lidocaine Delivery System Provides Rapid Effective Analgesia for Venipuncture or Cannulation Pain in Children: Randomized, Double-Blind Comparison of Venipuncture and Venous Cannulation Pain After Fast-Onset Needle-Free Powder Lidocaine or Placebo Treatment Trial Pediatrics, May 1, 2008; 121(5): 979 - 987. [Abstract] [Full Text] [PDF]

				I. Power Fentanyl HCl iontophoretic transdermal system (ITS): clinical application of iontophoretic technology in the management of acute postoperative pain Br. J. Anaesth., January 1, 2007; 98(1): 4 - 11. [Abstract] [Full Text] [PDF]

				M. Migdal, E. Chudzynska-Pomianowska, E. Vause, E. Henry, and J. Lazar Rapid, Needle-Free Delivery of Lidocaine for Reducing the Pain of Venipuncture Among Pediatric Subjects Pediatrics, April 1, 2005; 115(4): e393 - e398. [Abstract] [Full Text] [PDF]

				G. L. Kearns, J. Heacook, S. J. Daly, H. Singh, S. W. Alander, and S. Qu Percutaneous Lidocaine Administration Via a New Iontophoresis System in Children: Tolerability and Absence of Systemic Bioavailability Pediatrics, September 1, 2003; 112(3): 578 - 582. [Abstract] [Full Text] [PDF]