Local anesthesia in CVC

Q: During inserting non-tunneled Central Venous Catheter (CVC) in ICU, it is recommended to infiltrate a large amount of local anesthesia into subcutaneous (SC) tissues. 

A) True
B) False


Answer: B

Infiltrating skin and SC tissues with local anesthesia is needed prior to inserting CVC in ICU but large infiltration can cause two problems.

1.  a large infiltration of local anesthesia in the SC tissue will distort anatomical landmarks (particularly making it difficult if no bedside ultrasound is available).

2. A  large infiltration of local anesthesia in the SC tissue may compress vein making access more difficult, particularly in dehydrated patients.