Hawkins, A.S., Yoo, D.C., Movson, J.S., Noto, R.B., Powers, K., & Baird, G.L. (2014). Administration of subcutaneous buffered lidocaine prior to breast lymphoscintigraphy reduces pain without decreasing lymph node visualization. Journal of Nuclear Medicine Technology, 42, 260–264. 

DOI Link

Study Purpose

To assess whether anesthetizing the skin with buffered lidocaine before performing breast lymphoscintigraphy reduces pain

Intervention Characteristics/Basic Study Process

Patients were randomly assigned to the control group without lidocaine or the experimental group in which the procedure was preceded by lidocaine injection. Patients were asked to rate their pain levels before and immediately after injections for the procedure. All patients received two injections and were were masked from knowing whether one of them was lidocaine.

Sample Characteristics

  • N = 49   
  • MEAN AGE = 61.4 years
  • AGE RANGE = 34–87 years
  • FEMALES: 100%
  • CURRENT TREATMENT: Not applicable
  • KEY DISEASE CHARACTERISTICS: Breast cancer

Setting

  • SITE: Single site   
  • SETTING TYPE: Outpatient    
  • LOCATION: Rhode Island

Phase of Care and Clinical Applications

  • PHASE OF CARE: Diagnostic

Study Design

  • Randomized, controlled trial

Measurement Instruments/Methods

  • 0–10 numeric pain rating scale

Results

No difference in preprocedure pain levels existed between groups. Those who received lidocaine reported less of an increase in pain postprocedure. No difference in lymph node detection existed between groups.

Conclusions

Administration of local anesthetic prior to breast lymphoscintigraphy was associated with lower pain severity after the procedure.

Limitations

  • Small sample (< 100)
  • Risk of bias (no blinding)
  • Limited reporting of statistical results and methods

Nursing Implications

Authors point out that local anesthesia prior to lymphoscintigraphy is not common practice, due to the assumption that any benefit would be outweighed by the pain associated with additional needle sticks. Some patients may feel significant pain during this procedure, and findings from this study suggest an approach to reduce pain with this experience. Authors discuss the findings in terms of the rationale for using a buffered lidocaine solution and implications for practical application and needed lymph node visualization.