Painful Cannulation with Buttonholes

[Stuart Mott]

Go to this web site to see some cannulation techniques that you might use.

[Stuart Mott]

Are you still having problems?

[Unregistered]

I have a burning, allergic feeling when I first place my buttonhole needles, but once I tape them down it subsides. What causes this?

[Stuart Mott]

Are you using any type of pain meds such as lidocane? What type of needles are you using? Is the burning feeling on the surface or in the inner part of the access? Are you allergic to any thing? Do you get this when the tip of the needle is placed? Or after the needle is inserted in all the way? Are you cannulated by someone else?

[czs1994]

ss had trouble getting back on. Im only one cannulating. Pain in tunnel, surface and vein, have used both sized needles, upper arn transposition, wbc normal, never use sharps, hold wings lots of scar tissue build up. I sit when cannulating. No diff from first 4 painless years. Never used any pain meds.

[Unregistered]

Are you using any type of pain meds such as lidocane? What type of needles are you using? Is the burning feeling on the surface or in the inner part of the access? Are you allergic to any thing? Do you get this when the tip of the needle is placed? Or after the needle is inserted in all the way? Are you cannulated by someone else?

After washing and drying my access with antiseptic soap, I then use Lidocaine cream. That gets washed off in an hour and I then use alcohol and then Betadine to prepare my access. The burning is when my buttonhole needles are first placed in each site all the way. I self-cannulate. And then, as I said, as soon as each site is taped down, the burning subsists. If I was allergic to something, seems the burning would continue. But it is like an allergic burning feeling for the brief time it takes to tape the needles down only. It seems like I am getting the burning from either the metal needle coming into contact with the tunnel or possibly some Betadine is going in, although I usually wait til it is dry. Thankfully, the burning does not go on and on, but there is definitely a reaction there.

[M3Riddler]

After washing and drying my access with antiseptic soap, I then use Lidocaine cream. That gets washed off in an hour and I then use alcohol and then Betadine to prepare my access. The burning is when my buttonhole needles are first placed in each site all the way. I self-cannulate. And then, as I said, as soon as each site is taped down, the burning subsists. If I was allergic to something, seems the burning would continue. But it is like an allergic burning feeling for the brief time it takes to tape the needles down only. It seems like I am getting the burning from either the metal needle coming into contact with the tunnel or possibly some Betadine is going in, although I usually wait til it is dry. Thankfully, the burning does not go on and on, but there is definitely a reaction there.

Following Message sent from Stuart Mott by email and forwarded to Forum and Posted by ///M3Riddler:

It is the cream, I have noticed that if this is left on too long it has the tendency to make the skin too soft. There is no proof of this but try going without the cream for two weeks. It has been noted that for some patients this is true -- why I do not know. If you have buttonholes in most case it is not necessary to use the cream. Please try this and let me know. I''m sure other patents would interested in this.

Thank You



Stuart Mott
Vascular Access Nurse
Caring for you and your Patients

[Unregistered]

Hi,
I did not expect to get this answer. When I did ladder back method for years in-center, I read where a number of patients said that scar tissue builds up and it is no longer necessary to use Lidocaine cream as there is no more pain. I gave it a try on several occasions, but it did not work for me at all. I think patients must be very different in their pain tolerance and the cream has been a lifesaver for me. Same thing when it comes to BHs. I've tried it without cream and it does not work for me- the pain is certainly still there after many years of needles. I like the way the cream dissolves the scabs and they come off clean most nights when I wash well with antiseptic soap. Are you saying that because the skin is softened by the cream, that is what causes the burning feeling? Wondering what that would have to do with it? The cream allows pain to be blocked when the needles first go in. It's when the needles are placed in the tunnel that I feel the allergic, burning feeling. There is no cream in the tunnel- only the openings to the tunnels get softened. As soon as the needles are taped down it's over- only lasts for a few seconds. I could picture alcohol or betadine being pushed in with the needle or there being a reaction at first to the needle itself, but can't see where the cream is the culprit. Please know I respect you're experience, but not sure on this one.