Arterial buttonhole

I have been using two pairs of buttonhole sites for the last couple of months. The venous sites are always well-behaved. Not much pain. The tracts are well formed. The needle goes in smoothly. The arterial fellows are usually badly behaved. They give me trouble every night. Almost.

I don't know what the problem is, really. The needles do go in for the most part. But there is a stinging pain. I used to inject a little lignocaine which would make the actual cannulation comfortable (even if the lignocaine itself stung for a few seconds!). But I was told by many people to avoid using lignocaine. So, I tried that and have been avoiding it for the last few months.

A couple of days back, the arterial needle just wouldn't go in. No matter what I tried. Touch cannulation, rotating the needle slightly, pushing and tugging. Nothing worked. I then switched to a sharp needle and started the treatment.

The next night I used the alternate site and everything was fine. Last night, back to the troublesome site, I used a sharp again. I have no idea where this is going. But for the last couple for weeks, the thought of cannulation has me all worked up towards evening.

Sometimes I think, what the hell, just use the lignocaine, never mind the side effects. But then I think what if there are some really bad long term effects? So, I am trying to avoid it for now. Let's see how it goes.