I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: dyannalw on March 30, 2011, 01:54:34 PM
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I use lidacaine because I hate pain but the tech at the clinic said it is not good for your fistula. I was wondering how long a fistula can last while using lidacaine if anyone knows? Thank you.
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We used lodcaine for about 2 years.....
After that, Carl said it didn't really hurt much more without it than with it anyway! :lol;
His skin was getting VERY tough!
Aleta
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Try the Emla cream instead.
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The lidocaine will create more scar tissue than not using it, and I found that the pain of the lidocaine injection was acually greater than the pain of sticking without it.
It might be that lidocaine is better while the fistula is being built up or for patients with a very low pain threshold. There's one patient in my unit who makes a big fuss every time he gets stuck, but most I've seen are pretty stoic about it.
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I use numbing spray, ethyl chloride. It gets the job done for me. I have been needled a few times without because I couldn't get a refill right away, it wasn't horrible but I wouldn't go without the spray if I had a choice.
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I have used both Lindocaine in a topical spray form called Xylocaine and ethyl chloride. I prefer Xylocaine. I just don't know if that's bad for a fistula. I imagine Lindocaine injections would be bad, just as cannulating your fistula arm for non-renal purposes is bad
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When I started being needled I was adamant that I would not be needled without pain relief ie Lidocaine even though one of the nursing assistants who needles me alot and who started my buttonhole said it was not good for the fistula. The prick of the needle with the lidocaine actually hurt quite abit so I got some Emla Cream from my GP and I started using that however I was finding that I was still experiencing alot of pain when the sharp/buttonhole needles were used. So I thought, okay lets try it without the cream and do a comparison. I found that the pain was the same, made no difference for me. So I decided to be needled going forward without it. Still hurts but as my buttonhole tract is developing more and more it is getting abit easier.
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I started with Lidacaine, then went on to Emla. I wouldn't do without for a long time. Then (I think the Emla caused some reaction, so that I got scabs that looked like pork scratchings) I stopped using anything, and by then it didn't hurt. Most of the time now I don't even know that the needle has gone in.
So if you're anything like me, it should stop hurting in a while.
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I use lidacaine because I hate pain but the tech at the clinic said it is not good for your fistula. I was wondering how long a fistula can last while using lidacaine if anyone knows? Thank you.
I'm not sure there have been studies on long-term use of Lidocaine and fistulas. However, these are facts: Lidocaine is a vasoconstrictor, so it will cause the vein to become smaller and sometimes make it a little deeper, therefore actually harder to stick. This is especially true for newer fistulas.
Lidocaine causes a stinging, burning sensation when pushed, sometimes equal to or greater than dialysis needles. So why have 4 sticks when only 2 will give the same pain experience or even less? Plus, Lidocaine does cause greater scarring over time.
If needle pain is an issue for you, then try using EMLA cream, a topical anesthetic. There are over the counter cream applications available, but EMLA seems to work the best. To get maximum benefits, put a generous layer on your fistula at least one hour before treatment and cover the area with saran wrap. The deeper your fistula/graft is, the longer you need to allow the cream to stay on your skin. Just before getting "stuck," wash your arm and then use betadyne and alcohol swabs (or whatever your clinic procedure is).
If you are using the buttonhole technique on your fistula, it won't take very long before the tunnels are established and then blunt needles will be used. At this point if cannulation is done correctly, pain should be nominal.
If your nephrologist/vascular surgeon has suggested the rope technique for using your fistula is best, then you will need to use the EMLA for a while until a good needle "track" has been established and a layer of scar tissue has formed.
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My local pharmacist cannot get the name brand "EMLA" from any of his wholesalers... I tried just this past week to get a script filled so I would have it when I went into the hospital for the transplant. They could get me a generic lidocaine/prilocaine substitute, but not the name brand EMLA that I know works. I am going to pursue this more though, because I have used EMLA in the past for blood work sticks an it has helped immensely.
Interestingly enough, the nurses refuse to use inject able lidocaine here in the hospital to redo another I.V. I have had to have 4 done this week and insist they do something to ease the pain, but they won't. They say the lidocaine or whatever can give you heart palpitations/arrhythmias. The original O.R. prep nurse used it, but everyone else refuses...
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Well I tried the lidocaine cream yesterday and it worked pretty well. I felt the arterial needle go in but no pain and the second needle hurt a scratch but not like the lidocaine needle so it is doable. I am really happy I tried it. I put it on about 50 minutes before hand. Thank you for all your replies.
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My local pharmacist cannot get the name brand "EMLA" from any of his wholesalers... I tried just this past week to get a script filled so I would have it when I went into the hospital for the transplant. They could get me a generic lidocaine/prilocaine substitute, but not the name brand EMLA that I know works. I am going to pursue this more though, because I have used EMLA in the past for blood work sticks an it has helped immensely.
Interestingly enough, the nurses refuse to use inject able lidocaine here in the hospital to redo another I.V. I have had to have 4 done this week and insist they do something to ease the pain, but they won't. They say the lidocaine or whatever can give you heart palpitations/arrhythmias. The original O.R. prep nurse used it, but everyone else refuses...
Sax,
EMLA is the name brand of the product and cost much more than the generic brand... They both have the same ingredients and are the same product. other than one cost much more..... Any hosptial pharmacy has this and would be able to get it for you expecially if you are an in-patient. Only thing you may have to do is have one of your docs write for it. They wont give it to you just by asking..... Lidocain/prilocaine 2.5%/2.5%
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I'll tell you something I learned about the lidocaine cream. The warmer it is after it is on your arm, the better it numbs. I put my cream on and put plastic over it and then hold my hand over it to make it warmer. It really helps a lot.
Good Luck! :clap;