Compound lidocaine cream with warm compress for pain relief in ultrasound-guided peripherally inserted central catheter placement for cancer patients

Abstract

BACKGROUND

Ultrasound-guided peripherally inserted central catheter (PICC) placement is vital for cancer therapy, but lidocaine infiltration faces limitations like puncture pain and vasospasm.

AIM

To assess the clinical efficacy of a no-pain intervention-combining compound lidocaine cream with warm compress-in reducing pain during ultrasound-guided PICC placement in cancer patients.

METHODS

A retrospective cohort study analyzed 88 cancer patients undergoing PICC placement (Shanghai Fourth People’s Hospital, 2024). Patients were divided into control (lidocaine infiltration, n = 44) and intervention (cream + warm compress, n = 44) groups. Primary outcomes: Pain scores (numerical rating scale), procedural time, complications; secondary outcome: Satisfaction.

RESULTS

The intervention group showed significantly lower pain scores (1.2 ± 0.4 vs 3.8 ± 1.2, P = 0.012) with comparable first-attempt success (95.5% vs 90.9%) and safety (P = 0.672). Thermal activation of transient receptor potential vanilloid 1 channel enhanced drug penetration, achieving anesthesia within 8-10 minutes. Patient satisfaction reached 97.7%.

CONCLUSION

The combination of compound lidocaine cream with warm compress significantly alleviates procedural pain and enhances patient satisfaction during ultrasound-guided PICC placement in cancer patients, supporting its clinical application.

Keywords: Ultrasound-guided; Peripherally inserted central catheter placement; Pain relief; Compound lidocaine cream; Warm compress; Retrospective study; Cancer patients

Core Tip: This study presents a non-invasive analgesic protocol that combines compound lidocaine cream (2.5% lidocaine + 2.5% prilocaine) with a 40-45 °C thermal compress to mitigate pain during ultrasound-guided peripherally inserted central catheter placement in cancer patients. By leveraging thermos responsive mechanisms to enhance transdermal drug penetration, this method achieves dermal anesthesia within 8-10 minutes, effectively reducing initial puncture pain and minimizing the risk of vasospasm associated with traditional lidocaine infiltration. A retrospective analysis of 88 patients revealed significantly lower pain scores and a high level of patient satisfaction (97.7%), while maintaining procedural success rates comparable to conventional methods. Mechanistically, the thermal activation of transient receptor potential vanilloid 1 channel may facilitate deeper drug diffusion, providing rapid analgesia for urgent oncology interventions.