Benign anesthetists

We are all wary to a greater or lesser extent of the doctor advancing with needle and syringe. Arterial puncture required for blood gas analysis is a particularly painful procedure, certainly more painful than venipuncture. 

Many studies have demonstrated that administration of local anesthesia is effective in reducing pain associated with arterial puncture as well as venous cannulation, another common painful invasive procedure. Despite the evidence of efficacy, most non-anesthetist doctors do not employ local anesthesia prior to either procedure, according to the results of a recent questionnaire survey of 178 doctors working at eight UK hospitals. 

Only 2 % of junior doctors working on medical wards and none working on surgical wards routinely administer local anesthesia prior to arterial puncture, compared with 60 % of anesthetists. The figures relating to venous cannulation were a little more encouraging for patients. All anesthetists and close to 40 % of all other junior doctors reported using anesthesia prior to this procedure. 

The authors conclude that: "Junior doctors are giving their patients more pain than is necessary." In an accompanying editorial, a consultant anesthetist examines the reason for the disparity in practice between UK anesthetists and non-anesthetists revealed by the survey and champions the patients’ cause arguing that "….the pain of cannulation does matter and since we have the ability to prevent it at low cost and with negligible risk, how can we not justify it?" 

A protocol for the "virtually pain-free" administration of local anesthetic is included.