Painless IV Starts
Here's a technique that does away with the big "ouch."

Patients let us know how the IV venipuncture feels with a big "ouch." They often tell us that the IV start was one of the worst parts of their surgery, especially with multiple attempts. Allow me to share what we call the painless IV. It starts with a Xylocaine (lidocaine) skin wheel with an insulin syringe and a 28- or 29-gauge needle. Place the needle at a high (70- or 80-degree) angle to the skin. Next, inject adjacent to the vein, only in the very surface layer of the skin and not beneath the skin, .02ml to .03ml (two lines on the U-50 syringe). After a 30-second wait, the patient won't feel the venipuncture. Your first-time patients will say, "Wow, I didn't feel that." Your returning patients will request the "painless IV." One important note: Done incorrectly, the skin wheel can be more painful than the IV needle itself.

Robert R. Jirgl, CRNA
Anesthesia Service of Dowagiac
Dowagiac, Mich.
anesdowagiac@aol.com