| Harrison N, et al, 1991, UK1 | 60 patients for surgery Cannulation with 18G or 20G or 22G venflon on one arm v injection with 1% sub-cut lignocaine with a 25G needle on other arm. | Clinical trial Randomised Blinded | Pain using visual analogue scales | Cannulation significantly more painful than lignocaine injection in all groups | Some patients were pre-medicated |
| Langham BT and Harrison DA, 1992, UK2 | 60 patients for surgery Double cannulation with 18G, 20G or 22G venflons preceded by an injection of 1% sub-cut lignocaine with 25G needle on one arm v nothing on the other | Clinical trial Randomised Blinded | Pain using visual analogue scales | Cannulation without lignocaine significantly more painful than cannulation with lignocaine | Some patients were pre-medicated |
| Nuttall GA, et al, 1993, USA3 | 280 patients for surgery Cannulation with 18G venflon preceded by nothing v injection with 25G needle of 0.9% benzyl alcohol or 3% 2-chloroprocaine or 1% lignocaine or 1% lignocaine with preservative or 1% alkalinised lignocaine with preservative or normal saline | Clinical trial Randomised Double blinded Controlled | Pain using visual analogue scales | Cannulation without anaesthetic significantly more painful than cannulation with anaesthetic | |
| | | | Alkalinised lignocaine had the lowest mean pain score for cannulation | |
| Selby IR and Bowles BJ, 1995, UK4 | 160 patients for surgery Cannulation with 20G venflon preceded by nothing v cannulation preceded by EMLA or ethyl chloride spray or 1% sub-cut lignocaine injected with 25G needle. | Clinical trial Randomised | Pain on anaesthetic application, cannulation and a minute afterwards using visual analogue scales | Cannulation without lignocaine significantly more painful than lignocaine injection | Not blinded. Did not compare pain of whole procedure |
| | | Number of failed cannulations | No significant difference in number of failed cannulations | |
| Van den Berg AA, et al, 1995, USA5 | 278 patients for surgery Cannulation with 21G butterfly v 23G butterfly v 20G venflon v injection with 1% sub-cut lignocaine with 25G needle prior to cannulation with a venflon of any size | Clinical trial Randomised Blinded | Pain Subjectively using observation and objectively using visual analogue scales | Cannulation with 20G venflon and 21G butterfly significantly more painful than cannulation with 23G butterfly and anaesthetic injection before cannulation | Single blinded |
| Klein EJ, et al, 1994, USA6 | 59 children requiring cannulation in emergency department Cannulation with 18–24G venflons preceded by nothing v cannulation preceded by injection with 27G needle of sub-cut buffered lignocaine | Clinical trial Randomised | Pain of entire procedure using visual analogue scales | Cannulation without lignocaine significantly more painful than cannulation with lignocaine regardless of venflon size | Not blinded. Small sample size with wide confidence intervals |
| | | Number of attempts preceding successful cannulation | No significant difference in number of attempts | |
| Sacchetti AD, et al, 1996, USA7 | 110 children under 2 years requiring cannulation in emergency department | Clinical trial | Number of attempts preceding successful cannulation | No significant difference between groups | 2 groups entered into study over 2 different periods. Not blinded. Not randomised |
| Cannulation with 24G venflon preceded by nothing v cannulation preceded by injection with 27–29G needle of sub-cut lignocaine | | | | |
| Burgher SW, et al, 1998, UK8 | 103 patients requiring cannulation in emergency department Cannulation with 18G venflon preceded by nothing v cannulation preceded by injection with 27G needle of sub-cut buffered lignocaine or sub-cut 0.9% benzyl alcohol and normal saline | Clinical trial Randomised Blinded | Pain of anaesthetic injection and cannulation using visual analogue scales | Cannulation without lignocaine significantly more painful than lignocaine injection and significantly more painful than cannulation with lignocaine | Patients entered into study when investigators available and department not too busy. Did not compare pain of whole procedure |
| | | Number of attempts before successful cannulation and number of successful cannulations on the first attempt | No significant difference in number of attempts or success rate | |
| Fein JA, et al, 1998, USA9 | 99 children requiring cannulation in emergency department | Clinical trial Randomised | Pain using visual analogue scales | Cannulation without lignocaine significantly more painful than cannulation with lignocaine regardless of venflon size | Patients entered into study when investigators available |
| Cannulation with 18–24G venflons preceded by nothing v cannulation preceded by injection with 27G needle of sub-cut lignocaine or benzyl alcohol and normal saline | | | | |
| Holdgate A, et al, 1999, Australia10 | 166 patients requiring cannulation in emergency department | Clinical trial Randomised | Successful cannulation at first attempt | No significant difference between groups | Not blinded. Venflon size not considered |
| Cannulation preceded by nothing v cannulation preceded by injection with 25G needle of sub-cut 1% lignocaine | | | | |