Topicalizing for A-Lines

Do you guys routinely topicalize with lidocaine prior to placing awake A-Lines? I’ve had attendings tell me different things but in my mind - if I’m using ultrasound, im most likely going to get it in the first stick and so why torture the patient with lidocaine infiltration? (I’ve gotten lidocaine before a finger lac stitch once and it hurt like a B****!) We don’t topicalize for placing 20G IVs so why are A-Lines different?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Anesthesiology Source Type: forums