LIDOCAINE

[Bajanne]

Please help me!  What are the pros and cons of lidocaine usage?   Now that I am having the bigger needle, I can't take the pain.  But I want to know if it would be wise to take the pain.  Does anyone know of any downside to using lidocaine? It works so marvellously .  I feel absolutely nothing.

[Epoman]

Please help me!  What are the pros and cons of lidocaine usage?   Now that I am having the bigger needle, I can't take the pain.  But I want to know if it would be wise to take the pain.  Does anyone know of any downside to using lidocaine? It works so marvellously .  I feel absolutely nothing.

See this thread: http://ihatedialysis.com/forum/index.php?topic=194.msg919#msg919 that's what I posted before when you asked about lidocaine. I say take the pain and the skin will deaden and the pain will be less and less. Read my reply in the link above.

[LifeOnHold]

I was the biggest chicken in my unit-- I used lidocaine for 4 years before a charge nurse persuaded me to try it on just the venous for one treatment.  After that, I quit using it altogether... I discovered it hurt the same whether I got lidocaine or not!  (And I had 4 years' worth of extra scarring that I didn't need!)

Maybe you could try getting the lidocaine on one side, nothing on the other, and see what the difference is-- if it really hurts, you could go back to using lidocaine but at least you would know if you truly need it.

[queenie]

still having pain with cannulation?  ask your doc or nurse to write you a script for EMLA CREAM.  most insurances cover it.  it's a lidocaine cream, no extra needles, no extra scar tissue.  apply it liberally along your access about 30-60 min before dialysis, cover with regular plastic wrap, clean off before cannulation.  apparently, it's the shiznit.  everyone i know who uses it swears by it, even those who get stuck in the upper inner arm.   hope it helps.

[Rerun]

Hi Queenie,

It sounds like you know a lot about EMLA Cream, but do you use it?  Are you on Dialysis?  You have got some good tips.  Please go to the "Introduce Yourself" section and tell us where your experience comes from.   We need all the help we can get. 

I might try the EMLA Cream, but it sounds kinda messy.   

[kevno]

I have tried the cream, The only downside is you have to wait for up to an hour for it to work.  Even then for me I still felt the needle go in.  But it is worth a try Rerun it my be different for you. There again you know how I feel about needles.  I think I convinced myself it would not work.  I hate to try something different.  Just like to stay the same.  How boring is that.

Kevno
(Those Bloody Needles Again!!!)

[Bajanne]

They gave me the cream. (It's free here)  My problem is that I never remember until it is too late.  I am usually stepping out of my house and then I say "Darn, I should have used that cream!"  So I really don't even know if it works.
I continued to use Lidocaine, and now my skin in that area is extremely tough.  But there is only one nurse whom I trust to stick me without it.   If I don't get her, I use the lidocaine.

[Panda_9]

I use it, and have always used it. Once I forgot to use it and eventhough I buttonhole it hurt a bit. Had to use sharps on both buttonhole sites lastnight, and even with the xylocaine, it starts to hurt after it wears off. I really really dont like using sharps, but for some reason I just wasnt getting a flashback. After 4 attempts with blunts I gave up. 

[hyperlite]

I used to use Emla cream when I first started getting needled (freezing the first time, and then Emla without freezing from then on). At first this worked quite well for me. The emla cream completely froze my sites, and I had no problems at all. But it was a huge pain in the ass having to put on the emla cream an hour before dialysis, and then wrapping my arm in Seran-wrap so that the emla cream didnt rub off (you dont rub this stuff in, you just leave it "gooped" on). Plus in the summer time having to go around with my arm wrapped in seran-wrap was 1) not comfortable and 2) pretty annoying due to the stares i would get. So I eventually decided that a little pain was a lot better than the whole Emla cream process, and stopped using it (not to mention the hole it was putting in my pocket $$$). And then when i stopped using it, after about 3 more needlings, i realized that it hurt just the same, if not less without the emla! But just as long as I'm needled in the scar tissue...any deviance from that area and I sure can feel it. Haha kind of reminds me of the Nine Inch Nails / Johnny Cash song (about heroin addiction) Hurt: "The needle tears a hole. The old familiar sting..."

[Panda_9]

hyperlite, what do you mean by "freezing"?

[hyperlite]

by freezing i mean the needle they give you that numbs the spot...so you dont feel anything. A local i think?

[Bajanne]

As I shared in another posts, for the last three sessions, I had no lidocaine.  I will see what happens tomorrow.

[angieskidney]

Hi Queenie,

It sounds like you know a lot about EMLA Cream, but do you use it?  Are you on Dialysis?  You have got some good tips.  Please go to the "Introduce Yourself" section and tell us where your experience comes from.   We need all the help we can get. 

I might try the EMLA Cream, but it sounds kinda messy.   

OK I am just starting with the fistula (infact I am still on the 17ga needles but start the 15ga this Wed) but I will tell you, I use the Emla cream and it consists of Lidocaine 2.5% and prilocaine 2.5%.

You put it on (don't need much .. it is expensive for a small tube so make it last) but only on the area that will be cannulated. Put it on an hour before you will be sticked. Then cover it with plastic wrap to keep the warmth in because it is alcholol based and you don't want it to evaporate. Just before you are to be hooked to the machine wash your arm. As simple as that. If you don't want people staring at you if you stop for a snack on the way to dialysis just cover your arm with a bandage or something ..


So far it seems to be better with the cream for me but I am still new. The very first time I was poked I didn't have the cream because I didn't know that was "the day" 

[Bajanne]

No lidocaine again today and ALL WAS FINE.  Hurt like the dickens, but so does the lidocaine needle!

[angieskidney]

Today I used the cream again but this time for about 70 min instead of 50 like I have been. It is amazing the difference that made! It was wierd though not feeling anything in my arm though .. yet still even though my arm felt like it was NOT mine .. I could still feel the needles go in. Didn't hurt though. That was different.

[anja]

I inquired about the use of lidocaine in our local center and was told by the nurse that they NEVER use it here~  told by the head nurse it causes more scarring, so they will not use it.

[angieskidney]

I inquired about the use of lidocaine in our local center and was told by the nurse that they NEVER use it here~  told by the head nurse it causes more scarring, so they will not use it.

makes sense... the more you get poked the more scarring. I find the Emla cream works just as well anyway provided it is actually used the way I have just been using it. It does work.

[slothluvchunk]

I'd have to agree with Angie, Epoman, and others, that it's best to just "take it".

As far as lidocaine goes though, I've only used it once, when a nurse mis-read my order.  As a rule I don't want it.  I'd much rather have two sticks than four, and in my opinion, the sting from the lidocaine needle is worse than the dialysis needle!

As Epoman said, with enough sticks in your arm the skin hardens up like leather, and due to all the scar tissue the nerves basically stop growing there.  Right in that track, it's painless - numb in fact.

The pain of the needle I've found is very psychological - when I began sticking myself I was concentrating so much on not infiltrating, that I never even really felt the needles going in.  I'm convinced that if you're not paying attention to pain, it is simply another sensation for the brain to process.

Good luck!

[scyankee]

I MUST use the cream.  I, too have learned that the longer you put it on before treatment
the better it is with the needles.  For anyone who is going to have to start dialysis....make
sure your DR gives you a prescription for the cream BEFORE your first treatment!!!! My first
treatment was a nightmare without it. And don't listen to them when they tell you to put
it on 30 min. before treatments. DOES NOT WORK. Did THEY try it?
  Never heard of having lidocane injections. Would not want that because it means more needles!

[Panda_9]

I have buttonholes and I still get pain, even when Im just taking the scab off. I use a tiny bit of local which hasnt caused any problems. I dont find local painful, it only stings occaisionally. The sharp cannulas hurt for alot longer, even once Im hooked up. I think it is totally fine to use local until your buttonholes develop. I still use it just because that my choice, and my buttonholes are far from numb.

[AlasdairUK]

I do not use the EMLA cream as it is too much of a hassle, I never remember to put in on an hour before. It does numb the skin a bit but not enough for me. I also find that the size of the needle does not make that much of a difference.

[Zach]

I was once given about 20cc lidocaine as an IV push by accident.  I went into cardiac arrest, but came back to tell the story because of some fast thinking technicians doing CPR.

[Rerun]

I was once given about 20cc lidocaine as an IV push by accident.  I went into cardiac arrest, but came back to tell the story because of some fast thinking technicians doing CPR.

OMG you are kidding me!  Did any heads or head roll because of that little mistake? 

[Panda_9]

That is one big accident!!! I always triple checked meds before giving them, one time during my training a nurse said oh give this IV to this lady please, then she pissed off. I was standing there with this poor lady desperate for this drug, and because I didnt know if it was a push or in the bag I just put it in the bag, because it was sitting there opened on the bench. I then rang my supervisor to come down and check it with me as the nurse I was working with was no where to be found. Half an hour later the poor lady got her meds.
There was an incident with a student nurse in the ER. They accidently gave a drug IV that was supposed to be subcut, and the patient died. They were de-registered for life. It really wakes you up as to how important it is to check check check and know your 5 rights to medication administration.

[Zach]

OMG you are kidding me!  Did any heads or head roll because of that little mistake? 

The nurse got canned.