{"id":24991,"date":"2019-03-24T18:26:25","date_gmt":"2019-03-24T22:26:25","guid":{"rendered":"http:\/\/www.stepwards.com\/?page_id=24991"},"modified":"2025-03-21T22:18:49","modified_gmt":"2025-03-22T02:18:49","slug":"fundamental-technical-skills-in-interventional-radiology-administering-lidocaine-properly","status":"publish","type":"page","link":"https:\/\/www.stepwards.com\/?page_id=24991","title":{"rendered":"Fundamental Procedural Radiology Peri-Procedural Tasks: Administering Lidocaine Properly"},"content":{"rendered":"<div id=\"toc_container\" class=\"no_bullets\"><p class=\"toc_title\">Page Contents<\/p><ul class=\"toc_list\"><li><a href=\"#OVERVIEW\"><span class=\"toc_number toc_depth_1\">1<\/span> OVERVIEW<\/a><\/li><li><a href=\"#MAKING_A_WHEAL_WITH_LIDOCAINE\"><span class=\"toc_number toc_depth_1\">2<\/span> MAKING A WHEAL WITH LIDOCAINE<\/a><\/li><li><a href=\"#GIVING_LIDOCAINE_DEEPER_EXAMPLE_INTERNAL_JUGULAR_VEIN_ACCESS\"><span class=\"toc_number toc_depth_1\">3<\/span> GIVING LIDOCAINE DEEPER EXAMPLE: INTERNAL JUGULAR VEIN ACCESS<\/a><\/li><li><a href=\"#GIVING_LIDOCAINE_DEEPER_EXAMPLE_PARACENTESIS\"><span class=\"toc_number toc_depth_1\">4<\/span> GIVING LIDOCAINE DEEPER EXAMPLE: PARACENTESIS\u00a0<\/a><\/li><\/ul><\/div>\n<h5><span id=\"OVERVIEW\"><span style=\"text-decoration: underline;\">OVERVIEW<\/span><\/span><\/h5>\n<p><strong>Administering lidocaine<\/strong> will be the first time that the patient&#8217;s skin is punctured. It is an opportunity to help control the patient&#8217;s pain and discomfort, however if not administered properly can lead to unnecessary pain and rattle the confidence of new trainees. It is a simple task but is nuanced. As a result look over the content below to learn more about how to <strong>administer lidocaine properly<\/strong>.<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/p4bZH0P9ZLE\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong><u>Key Points To Keep In Mind When\u00a0Administering\u00a0Lidocaine:<\/u><\/strong><\/p>\n<ul>\n<li><strong>Use buffered lidocaine:\u00a0<\/strong>lidocaine is acidic, and its administration will actually give a burning sensation as a result. To limit the pain from the lidocaine a buffered solution can be used. Typically 1% lidocaine is buffered with sodium bicarbonate (one part sodium bicarb to 9 parts 1% lidocaine).<\/li>\n<li><strong>Use the right size needle:\u00a0<\/strong>typically a 25 gauge needle is used for injecting lidocaine.<\/li>\n<li><strong>Make an intradermal skin wheal first:\u00a0<\/strong>the pain receptors are found in this layer, so it is important to make sure that this location is properly anesthetized with local anesthetic.<\/li>\n<li><strong>Begin\u00a0your\u00a0injection with the needle bevel up, parallel to the skin, and by dripping out your\u00a0lidocaine as you break into the skin:\u00a0<\/strong>this will ensure that once you enter the right layer of skin you being creating your wheal immediately (and helps avoid sticking in too deep unnecessarily). The video below helps demonstrate this technique in further detail.<\/li>\n<\/ul>\n<h5><span id=\"MAKING_A_WHEAL_WITH_LIDOCAINE\"><span style=\"text-decoration: underline;\">MAKING A WHEAL WITH LIDOCAINE<\/span><\/span><\/h5>\n<p>When you are prepared to inject lidocaine, your first injection will be an intradermal injection (similar to placing a PPD) and your goal will be to make a skin wheal. This technique is shown in greater detail in the video below:<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/rtnJKiAUkTM\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h5><span id=\"GIVING_LIDOCAINE_DEEPER_EXAMPLE_INTERNAL_JUGULAR_VEIN_ACCESS\"><span style=\"text-decoration: underline;\">GIVING LIDOCAINE DEEPER EXAMPLE: INTERNAL JUGULAR VEIN ACCESS<\/span><\/span><\/h5>\n<p>The video below shows how lidocaine can be used to numb deeper tissues under ultrasound guidance. In this example lidocaine is used to prepare the deeper tissues for an internal jugular vein puncture under ultrasound guidance.<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/RbrLj83j4Vk\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h5><span id=\"GIVING_LIDOCAINE_DEEPER_EXAMPLE_PARACENTESIS\"><span style=\"text-decoration: underline;\">GIVING LIDOCAINE DEEPER EXAMPLE: PARACENTESIS\u00a0<\/span><\/span><\/h5>\n<p>The video below shows how lidocaine can be used to numb deeper tissues under ultrasound guidance. In this example lidocaine is used to prepare the deeper tissues for a paracentesis under ultrasound guidance.<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/Eo-aCOTLF88\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<pre>Page Updated: 03.24.2019<\/pre>\n","protected":false},"excerpt":{"rendered":"<p>Page Contents1 OVERVIEW2 MAKING A WHEAL WITH LIDOCAINE3 GIVING LIDOCAINE DEEPER EXAMPLE: INTERNAL JUGULAR VEIN ACCESS4 GIVING LIDOCAINE DEEPER EXAMPLE: PARACENTESIS\u00a0 OVERVIEW Administering lidocaine will be the first time that the patient&#8217;s skin is punctured. It is an opportunity to help control the patient&#8217;s pain and discomfort, however if not administered properly can lead to &#8230; <a title=\"Fundamental Procedural Radiology Peri-Procedural Tasks: Administering Lidocaine Properly\" class=\"read-more\" href=\"https:\/\/www.stepwards.com\/?page_id=24991\" aria-label=\"More on Fundamental Procedural Radiology Peri-Procedural Tasks: Administering Lidocaine Properly\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":25154,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_mi_skip_tracking":false},"jetpack_shortlink":"https:\/\/wp.me\/P71awf-6v5","_links":{"self":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/24991"}],"collection":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24991"}],"version-history":[{"count":7,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/24991\/revisions"}],"predecessor-version":[{"id":25734,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/24991\/revisions\/25734"}],"up":[{"embeddable":true,"href":"https:\/\/www.stepwards.com\/index.php?rest_route=\/wp\/v2\/pages\/25154"}],"wp:attachment":[{"href":"https:\/\/www.stepwards.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}