Topical lidocaine-ibuprofen versus lidocaine-prilocaine as a Local Anesthetic Agent in Reducing Central Venous Catheter Insertion Pain: a Randomized Controlled Trial

Objective: This study was performed to evaluate the effectiveness of topical lidocaine-ibuprofen combination compared to lidocaine-prilocaine combination (Xyla-P) in reduction of the pain during central venous catheter (CVC) insertion.
Methods: In this randomized clinical trial, 100 adult patients requiring CVC insertion in the emergency department (ED) were enrolled. These patients were divided randomly into two groups. The site of CVC insertion was covered with topical Xyla-P cream (2 g) in the first group, and topical lidocaine-ibuprofen (2 g) cream in the second group. The primary outcome was assessment of pain during CVC implantation. The secondary outcomes were physician’s satisfaction and the incidence of side effects.
Results: The mean age was 41.67 ± 9.66 years (range 18–61), and 36% of patients were female. The mean VAS pain score during CVC insertion was 4.61 ± 2.05 in the LP group and 3.86 ± 2.09 in the LI group, respectively (mean difference of 0.75 [95% confidence interval (CI): -0.80 to 1.56]), The mean VAS pain score during lidocaine injection was 1.78 ± 0.79 in the LP group and 1.52 ± 0.79 in the LI group, respectively (mean difference of 0.26 [95% CI: -0.05 to 0.57]), The physician’s satisfaction did not show statistically significant differences between two groups.
Conclusion: This study showed that topical lidocaine-ibuprofen is as effective as Xyla-P in relieving acute pain during CVC insertion.