The Effect of Buffered Prilocaine on Injection Pain During Central Venous Port Catheter Placement

Öz

Abstract Objective: This study aimed to assess whether alkalinization of 2% prilocaine with sodium bicarbonate reduces injection-related pain during central venous port catheter placement. Methods: A total of 67 patients who underwent central venous port catheter placement under local anesthesia between January and December 2021 were retrospectively evaluated. In all cases, non-buffered prilocaine was applied at the jugular vein access site, and injection-related pain was assessed using a 0–10 numeric rating scale. Patients were categorized into two groups based on the anesthetic solution used for port pocket (pectoral region) anesthesia. Group A consisted of patients who received buffered prilocaine (n = 37), whereas Group B included those who received non-buffered prilocaine (n = 30). The groups were compared in terms of demographic and clinical characteristics, as well as numeric pain scores for jugular and pectoral injections. Results: The two groups showed no significant differences regarding age, sex distribution, smoking history, body mass index, or pectoral subcutaneous tissue thickness (all p > 0.05). Jugular injection pain scores were similar between Group A and Group B (2.9 ± 1.4 vs. 2.9 ± 1.3, respectively; p > 0.05). In contrast, the pectoral injection pain score was significantly lower in Group A compared with Group B (2.6 ± 1.5 vs. 3.5 ± 1.6, respectively; p = 0.011). No local anesthesia–related complications or allergic reactions were observed. Conclusion: Buffering prilocaine with sodium bicarbonate significantly reduces injection pain during local anesthesia in central venous port catheter placement.

Anahtar Kelimeler

• Injection pain
• Local anesthesia
• Central venous port catheter
• Sodium bicarbonate

Santral Venöz Port Kateter Uygulamalarında Prilokainin Sodyum Bikarbonat ile Alkalizasyonunun Enjeksiyon Ağrısına Etkisi

Öz

Amaç: Bu çalışmanın amacı, santral venöz port kateter uygulamalarında lokal anestezi amacıyla kullanılan %2 prilokainin sodyum bikarbonat ile alkalize edilmesinin enjeksiyon ağrısı üzerindeki etkisini değerlendirmektir. Yöntem: Ocak-Aralık 2021 tarihleri arasında lokal anestezi altında santral venöz port kateter yerleştirilen 67 hasta retrospektif olarak incelendi. Tüm hastalarda juguler ven giriş bölgesine non-tamponize prilokain uygulanarak enjeksiyona bağlı ağrı 0-10 arası numerik ağrı skalası ile kaydedildi. Hastalar port cebi (pektoral bölge) anestezisinde kullanılan solüsyona göre iki gruba ayrıldı: tamponize prilokain uygulanan hastalar Grup A (n=37) ve non-tamponize prilokain uygulanan hastalar Grup B (n=30). Gruplar demografik ve klinik özellikler ile juguler ve pektoral enjeksiyon numerik ağrı skorları açısından karşılaştırıldı. Bulgular: Gruplar arasında yaş, cinsiyet, sigara öyküsü, vücut kitle indeksi ve pektoral cilt altı kalınlığı açısından anlamlı fark saptanmadı (tümü p>0,05). Juguler enjeksiyona bağlı ağrı skorları Grup A’da 2,9 ± 1,4, Grup B’de ise 2,9 ± 1,3 olarak saptandı ve gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (p>0,05). Buna karşın pektoral enjeksiyon ağrı skoru Grup A’da 2,6±1,5, Grup B’de 3,5±1,6 idi ve aradaki fark istatistiksel olarak anlamlı bulundu (p=0,011). Hiçbir hastada lokal anesteziye bağlı komplikasyon veya alerjik reaksiyon izlenmedi. Sonuç: Prilokain solusyonunun, sodyum bikarbonat ile tamponize edilmesi, santral venöz port kateter uygulamalarında lokal anestezi sırasında oluşan enjeksiyon ağrısını anlamlı düzeyde azaltmaktadır.

Anahtar Kelimeler

• Lokal anestezi
• Santral venöz kateterler
• Sodyum bikarbonat
• Ağrı

Kaynakça

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