Peripherally inserted central catheter insertion problems associated with topical anesthesia.

Application of the topical anesthetic cream to the antecubital fossa 60 minutes before insertion of the peripherally inserted central catheters resulted in significant vasoconstriction and/or vasospasm in 24 patients. Catheter insertion was difficult in all 24 patients. Advancement of the peripherally inserted central catheter was impossible in six patients. Of the 51 patients that did not have the topical anesthetic pre-catheter insertion, there were no difficulties in placing the lines, nor were there any vasoconstriction and/or vasospasm. This group included 66 adults and 9 children.