How to make cancer patients have less pain during subcutaneous implantable venous access devices insertion: the effect of buffered lidocaine.

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Abstract Purpose: Subcutaneous implantable venous access devices are of great importance for the administration of chemotherapy in cancer patients. They are routinely implanted under local anesthesia. However, patients complain of pain during the injection of local anesthesia. Alleviating pain for cancer patients is of high importance. Our aim was to evaluate the effectiveness of sodium bicarbonate-buffered lidocaine with epinephrine on reducing pain and patients’ satisfaction during subcutaneous implantable venous access devices insertion.Methods: A prospective double-blind study was conducted over a period of 6 months (January 2017 to June 2017) in a department of anesthesiology in Tunisia. Cancer patients were randomized to receive either buffered (PH= 7.33) or plane lidocaine (PH= 3.50). Pain and satisfaction were evaluated on a VAS score (0-100 mm). Results: One hundred twenty patients were enrolled in this study with sixty patients in each group. Mean pain scores during local anesthesia infiltration were 15.7 ± 7.6 mm vs.46.9 ± 12.3 mm respectively in the study and control group (p<0.001). Mean VAS satisfaction was 95.75±8 mm in the intervention group and 70.2±20.1 mm in the control group (p<0.001). Conclusion: Adjusting the pH of anesthetic agents could minimize pain during PortACath insertion and improve satisfaction of cancer patients.

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