Usefulness of Iontophoresis for Delivering Lidocaine in Local Anesthesia for Pain Related to Shunt Puncture in Patients Undergoing Dialysis

We investigated the usefulness and effectiveness of iontophoresis (IP) for the delivery of lidocaine in local anesthesia during shunt puncture for patients undergoing dialysis since IP has not previously been used for this purpose. Initially, we determined the optimal dosing time and concentration of lidocaine in 14 healthy adults by the pin prick method, finding that the administration of a 1% lidocaine solution by IP for 15 min induced significant local anesthesia and the anesthetic effect was comparable to that achieved by Lidocaine tape (Penles®) for 120 min. These two methods of administering local anesthesia were also similar as regards adverse reactions. We then investigated the usefulness of IP for delivering the 1% lidocaine solution for 15 min in obtaining local anesthesia for shunt puncture in 14 patients undergoing dialysis. Again there was no marked difference in the local anesthesic effect between IP and Penles®. The incidence of adverse reactions, however, was significantly lower with IP than with Penles®, though there was no difference in the degree of patient satisfaction. These findings suggest that the administration of lidocaine via IP is superior to Penles® as a method of delivering lidocaine, and would be useful for patients undergoing dialysis who have forgotten to apply Penles® before dialysis sessions at a hospital and patients in whom the puncture site has to be changed due to dermal disorders.