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From the prehospital literature
 Edited by Malcolm Woollard, from the British Paramedic Association Research and Audit Committee and the Faculty of Prehospital Care Research Unit
  1. Craig Raybould
  1. Correspondence to:
 Craig Raybould
 BMJ Publishing Group, BMA House, Tavistock Square, London, UK; craybould{at}

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Needle-free delivery of 0.5 mg lidocaine before venepuncture considerably reduces pain in paediatric patients ▸

Needle insertion and intravenous cannulation have been found to be a painful and frightening experience for children. This double-blind, randomised, placebo-controlled study compared the delivery of 0.5 mg lidocaine, 0.25 mg lidocaine and placebo in 144 paediatric patients undergoing venepuncture through a single-use, needle-free drug delivery system (ALGRX 3268, AlgoRx Pharmaceuticals, Secaucus, New Jersey, USA). This system administers powdered drug into the epidermis for inducing local anaesthesia in 2–3 min. Pain scores were measured using the Faces Pain Scale Revised (FPS-R) and Visual Analogue Scale (VAS). A significant reduction was observed in mean VAS pain scores of –0.428 in the 3–7-year-old group of patients treated with 0.5 mg lidocaine compared with placebo (95% confidence interval (CI) –0.834 to –0.022). The reduction in pain for patients treated with 0.25 mg lidocaine was not significant. It was concluded the needle-free drug delivery system configured to deliver 0.5 mg lidocaine …

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