Lignocaine-free cannulation

Lignocaine is a local anesthetic. As I wrote here, it is quite an oxymoron. I started using a little lignocaine after cannulations began being painful despite using buttonhole needles. Everyone would ask me to try not to use it. No one ever told me why. They would simply say it was not needed.

The reason I used it was that the cannulation itself would be painless. The injecting of the lignocaine itself produced a sharp stinging pain for a few seconds. But I would still use it thinking that this would prevent a possibly deeper and more long lasting pain after putting in the dialysis needles.

Recently, however, I was visited by a team from Fresenius including one of their senior clinical coordinators. They said the same thing. "You should not need it". I had had enough. I decided to try it out. So, I cannulated without using lignocaine. It wasn't bad at all. Especially since I was using buttonhole needles.

A few days back however, I had to create a new buttonhole site since there was a problem with the old site. For this I had to use a sharp needle. Now, this was a different ball game. Buttonhole needles are blunt and you just have to push them through the tract that has been already created earlier (using sharps). But sharps have, well, sharp ends and can be quite painful. But I had some confidence from the previous few nights. So, I decided to go for it without lignocaine even for the sharps.

It was totally ok. I would say the pain with sharps is about the same as the pain of injecting lignocaine itself.

Day before yesterday, the new buttonhole site was also ready. So, now I am back to using buttonhole needles daily. I have two pairs of sites which I alternate every night.