ACUTE PAIN INDUCED BY INTRAVENOUS POTASSIUM-CHLORIDE.
Contributors: University of Utah.
Published: 1986
Number of pages: 153
Subjects: Health Sciences, Nursing.
Description: Critical-care nurses have observed the occurrence of acute pain with intravenous infusions of potassium chloride (KCl) boluses. Acute pain at the infusion site of a potassium chloride bolus is an iatrogenic discomfort caused by correcting a potential life-threatening situation. Accepted actions of nurses include the relief of pain. Yet in critical care situations with patients diagnosed as hypokalemic, nursing actions to relieve pain produce pain with administration of a KCl bolus. Nurses have also observed that hypokalemic patients who receive lidocaine intravenously for cardiac arrhythmias with a KCl bolus piggybacked to the lidocaine do not experience acute pain.

The purpose of this study was to determine whether or not lidocaine could be combined safely with an intravenous bolus of potassium chloride to control the acute pain induced by a KCl bolus.

An experimental design using an animal model composed of male Sprague-Dawley rats was used to study the effects of combining lidocaine with a KCl bolus. Serum, skin, tissue and muscle levels of K('+), Na('+) and Cl('-) were measured in groups of rats. Equilibrium potentials for K('+), Na('+) and Cl('-) were calculated for all samples. Histology slides of rat tail sections were examined to determine whether venous cellular damage occurred when tail veins were infused with: (1) D5W with a KCl bolus in diuresed animals, (2) D5W with a KCl bolus combined with lidocaine in diuresed animals, (3) D5W in diuresed animals, and (4) D5W in nondiuresed animals.

Analyses of data suggest that KCl bolus pain is due to an increase in potassium equilibrium potential. With lidocaine administration, reduction in the K('+) equilibrium potential occurs and cells adjacent to the infusion site have a longer time to reach depolarization threshold. It is hypothesized that reduction in the K('+) equilibrium potential when lidocaine is infused increases resting time of the cell and decreases the chance of nerve fiber firing, thus decreasing the pain impulses.

Further studies are needed using the human model to include subjective and objective measures of pain and pain control when different concentrations of potassium chloride and potassium chloride combined with lidocaine are infused into peripheral veins.
Notes: Source: Dissertation Abstracts International, Volume: 47-07, Section: B, page: 2838.

Thesis (PH.D.)--THE UNIVERSITY OF UTAH, 1986.

School code: 0240.