The Journal of emergency medicine · 2025
10% Lidocaine Versus 1% Diclofenac Spray in Radial Arterial Blood Gas Sampling: A Randomized, Double-Blind, Placebo-Controlled Trial using Perfusion Index.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Altundağ Ibrahim, Doğruyol Sinem, Yavuz Burcu Genç, Afacan Mustafa Ahmet, Çolak Şahin
Аннотация
BACKGROUND: Radial arterial blood gas (ABG) sampling is a common but painful procedure essential for assessing critically ill patients. Effective pain control is vital for patient comfort and procedural success.
OBJECTIVE: This study aimed to compare the analgesic efficacy of topical 10% lidocaine and 1% diclofenac sprays versus placebo in alleviating pain during radial ABG sampling. We also explored perfusion index (PI) as an objective pain assessment tool.
METHODS: This randomized, double-blind, placebo-controlled study was conducted in the emergency department. A total of 150 patients undergoing radial ABG sampling were randomly assigned to three groups: placebo (n = 50), 10% lidocaine (n = 50), and 1% diclofenac (n = 50). Baseline perfusion index (PI0) was recorded, sprays applied, and a 10-min waiting period followed. After ABG sampling, post-procedure measurements were obtained, including PI1 and pain intensity assessed using the Visual Analog Scale (VAS). Analgesic effects were compared based on VAS scores and changes in PI (ΔPI and %ΔPI).
RESULTS: The mean post-procedure VAS scores were 4.18 ± 2.09 (lidocaine), 4.80 ± 2.70 (diclofenac), and 4.90 ± 2.59 (placebo), with no significant differences between groups (p = 0.292). As a secondary finding, a moderate positive correlation was observed between VAS scores and %ΔPI (r = 0.379, p < 0.001). PI significantly decreased in all groups after ABG sampling, but no significant differences were observed among groups.
CONCLUSION: Topical 10% lidocaine and 1% diclofenac sprays did not provide significant pain relief compared to placebo. Although a moderate correlation between VAS and PI was observed, further research is needed to establish PI's clinical utility.
TRIAL REGISTRATION: ClinicalTrials.gov (NCT06918340).
OBJECTIVE: This study aimed to compare the analgesic efficacy of topical 10% lidocaine and 1% diclofenac sprays versus placebo in alleviating pain during radial ABG sampling. We also explored perfusion index (PI) as an objective pain assessment tool.
METHODS: This randomized, double-blind, placebo-controlled study was conducted in the emergency department. A total of 150 patients undergoing radial ABG sampling were randomly assigned to three groups: placebo (n = 50), 10% lidocaine (n = 50), and 1% diclofenac (n = 50). Baseline perfusion index (PI0) was recorded, sprays applied, and a 10-min waiting period followed. After ABG sampling, post-procedure measurements were obtained, including PI1 and pain intensity assessed using the Visual Analog Scale (VAS). Analgesic effects were compared based on VAS scores and changes in PI (ΔPI and %ΔPI).
RESULTS: The mean post-procedure VAS scores were 4.18 ± 2.09 (lidocaine), 4.80 ± 2.70 (diclofenac), and 4.90 ± 2.59 (placebo), with no significant differences between groups (p = 0.292). As a secondary finding, a moderate positive correlation was observed between VAS scores and %ΔPI (r = 0.379, p < 0.001). PI significantly decreased in all groups after ABG sampling, but no significant differences were observed among groups.
CONCLUSION: Topical 10% lidocaine and 1% diclofenac sprays did not provide significant pain relief compared to placebo. Although a moderate correlation between VAS and PI was observed, further research is needed to establish PI's clinical utility.
TRIAL REGISTRATION: ClinicalTrials.gov (NCT06918340).