CCCF ePoster library. Pek J. Nov 1, 2016; 150958; 77
Dr. Jen Heng Pek
Dr. Jen Heng Pek
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Topic: Clinical Trial


Pek, Jen Heng; Seth, Puneet; Wong, Evelyn

Department of Emergency Medicine, Singapore General Hospital, Singapore



Introduction: Intravenous potassium replacement using potassium chloride is indicated for treatment of severe hypokalemia, symptomatic hypokalemia and patients who cannot use oral therapy. Patients often complained of pain during the replacement process. Current interventions to reduce pain include slowing the rate of replacement, adding a diluent, applying ice pack and using large bore cannula. The administration of intravenous lignocaine prior to the infusion may have a role in reducing the pain experienced by this group of patients. Safety concerns have limited its clinical application.

Objectives: The primary objective was to determine the effectiveness of lignocaine in reducing pain experienced during potassium chloride infusion. The secondary objective was to determine the adverse events associated with intravenous lignocaine use for this purpose.

Methods: A prospective study was carried out in the department. The lignocaine protocol which involved giving 30mg of 1% lignocaine intravenously 1 minute before starting the potassium chloride infusion was made known to all staff. In this pragmatic trial, the decision to use this protocol was left to the discretion of the attending doctor when managing a patient with hypokalemia requiring intravenous replacement. The nurse taking care of the patient would record any experience of pain during the infusion. Occurrence of adverse event was recorded.

Results: A total of 96 patients were recruited with equal numbers receiving and not receiving lignocaine prior to the potassium chloride infusion. Eight patients who received lignocaine experienced pain during potassium chloride infusion, as compared to eighteen patients who did not receive lignocaine. The relative risk was 0.44 (0.21-0.92), p =0.03. The absolute risk reduction was 0.21 and the number needed to treat was 5. There was no adverse event associated with the lignocaine protocol in this study.

Conclusion: Intravenous lignocaine was effective and safe when used to reduce pain associated with potassium chloride infusion.


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