I Hate Needles! The Secrets Behind the IV

| April 30, 2012 | 14 Comments

Do you hate needles? Are you afraid of the iv? Are you a difficult intravenous stick? Learn what to do if you are scared to death of having an iv placed before surgery.

For many patients, the “iv” can be the scariest part of having surgery. Sometimes they have a fear of needles or perhaps they have had a difficult experience in the past.  Having a little background information may help the iv placement be a little less scary to you.

An iv refers to an intravenous line, which is a way of giving medicines and fluids into a vein.  Veins are vessels that carry blood from your body back to your heart.  They are located all over your body.  You can often see or feel them in your hands, arms, feet, and neck.  Some are tiny and others are much larger, like the veins that connect directly to your heart.

But why do you have to have an iv?   An iv is needed to give you all types of medicines including anesthesia.  And the bag of fluid connected to the iv is used to move this medicine along in your vein.  Some medicines may be given by mouth, under the tongue, into the nose, or even other less desirable places.  But we need medicines to act quickly, and an iv is the way to get this done.

If you haven’t had an iv before, try not to worry too much about it.  I know this is easier said than done, but the nurse or doctor placing the iv can use numbing medicine.  This is similar to the medicine you may receive at the dentist’s office.  It can be placed in the skin where the iv will be started and usually stings for just a second or two.

The iv may be placed in many different areas.  But not to fear, the person placing the iv will use the area that they feel will be the most successful.  In other words, the area that will be the least uncomfortable for you, taking into account the type of surgery you are having.  For instance, the “best” vein you have may be in your right hand, but if you are having right carpal tunnel surgery, the iv cannot be placed in that hand.

If you are reading and thinking to yourself, I wish it was that simple for me, this part is for you.  It is possible that healthcare personnel have a difficult time placing an iv into your veins.  This can be due to a variety of reasons that are often out of your control.  But patients who are obese or have used iv drugs in the past are notoriously more difficult for iv placements.  Others have unfortunately had to go through multiple iv chemotherapy treatments or frequent iv treatments for things such as kidney disease.  Something common to every patient undergoing elective surgery is that you have been fasting and this makes your veins less full and visible.

If you have been told or you know that you are a “difficult stick” (I don’t like this term), what can you do?  I suggest that you tell the person up front putting in your iv that it has been difficult for you  in the past.  Tell them where you had a successful iv before and often that vein will still be available.  You can ask for the most experienced person around to place the iv if you want.  This is definitely not an unreasonable request.

If you are someone who has a fear of needles, don’t worry, this is pretty common.  Not many people really like needles, but for some patients, even the thought of needles causes severe anxiety.  Once again, you are not the only person that feels this way and we understand what you are going through.  We have an assortment of techniques we can use to help make the experience the least uncomfortable for you.  Don’t forget to ask for the person who successfully placed your iv last time.  They may be around that day or night.

I hope this helps you even if you hate needles!

What General Anesthesia Side Effect have you experienced, if any?

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Category: Day of surgery

Comments (14)

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  1. Kyle says:

    This was a helpful post, and I guess I do get a little anxious about needles…but why do I get “woozy” every time I get blood drawn or even just my flu shot (especially if I watch)? I am worried that when I get an IV it will be so much worse! Might this be a problem, or is there any way I can avoid getting woozy or fainting? Thanks.

    • Dr Dave says:

      Hi Kyle,

      Thanks for the great comment. When you get “woozy”, this is known as a vasovagal response. The stress and anxiety of the IV placement causes your heart rate and blood pressure to decrease, making you feel light-headed. You may even pass out.

      It’s important to let the person who is placing the IV know about this possible reaction. They should then make sure that they have equipment available to assess your vital signs, administer oxygen, and possibly have you lay in a gurney where they can easily lay you flat (or head down) should it become necessary.

      And it always help to just look away! Hope this helps.

      Dr. Dave

  2. I am having surgery on 9/13 and I am considered a “hard stick”, unfortunately I have never come across a pre op nurse with much sympathy. As far as I am concerned, getting the IV is the worst part of surgery. Please tell me, is there anything I can say to help with my anexity? Thank you for your help.

    • DrJoe says:


      I am so thankful that you have asked this question because I believe you will help a lot of others out! I definitely feel for anyone that is a “hard stick” because of the agony that you must have to go through every time you have a procedure. Getting the IV is the worst part of surgery for you I am sure. Because after that, all you experience is falling asleep and waking up in the recovery room.

      Okay, this is what I would suggest: Bring a family member or friend with you for support. This person can hold your hand and help comfort you during this difficult time. Next, tell the person who is going to start your IV that you are a “hard stick.” Not that you were a hard stick, but that you are a hard stick. Please let them know where IV placement has been successful for you in the past. Let them know this up front before they get started.

      If you have been told your veins “roll” or that they “blow” easily, let the nurse or doctor starting your IV know this. And tell them where this has happened to you (hand, wrist, arm, etc). Give them as much information as you can. This way, they won’t try and place an IV in area that you know just won’t work. Many times we see veins that we think may work well, but they just don’t, and they have never worked before for an IV placement. So let everyone know.

      I would let your surgeon know about this situation as well. Perhaps he or she can schedule your surgery on 9/13 at a time when there is plenty of time for someone to start your IV.

      Occasionally when someone is a hard stick, we will elect to place the IV in the neck. I know this sounds frightening, but with numbing medicine, most people do not say this is any more uncomfortable than an IV placed in the hand or arm.

      I realize your question is about what to say to help with your anxiety, though. So in summary, I would let everyone that is taking care of you know that you are a difficult stick. Give them all the information you have about past IV placements. That way, they don’t try to “reinvent the wheel,” and they start with what has worked for you in the past. And try to relax as much as you can during the process (I know this is much easier said than done). This will help give the person starting your IV the best chance for success on the first try.

      I really hope this helps and best of luck to you on the 9/13. Let us know how it goes.

      Dr. Joe

  3. Hannah says:

    I need to have a tooth extracted and the needle will be in my mouth. I am utterly terrified. The dentist knows that I am fearful, but I am immune to both gas-and-air and numbing paste, which means I have no pain protection. Do you know what I could do?

    • Dr Dave says:


      I understand how terrifying it must be to have this fear of needles, and yet need to have a tooth extraction.

      I am not sure what you mean by “immune to gas and air””. Are you referring to the “laughing gas” that is sometimes used in dental offices? It would be very unusual to be “immune” to this. I imagine it may have been previously used in a low concentration.

      It would also be extremely rare to be “immune to numbing paste”. If it was used before and did not adequately numb the targeted area, it may not have been given enough time to work. Those numbing pastes typically contain various local anesthetics, and they can take some time to peak effect. Depending on the type of local anesthetic, it can take 15 – 20 minutes to work.

      My suggestion would be to consider using the numbing gel and letting your dentist know it hasn’t worked properly in the past. Perhaps he/she can give it more time to work this time around. Then the dentist can “numb you some more” by going through the tissue that is already numb from the gel.

      If you close your eyes and try not to think about it, perhaps this technique will allow you to feel nothing more than “pressure” where the dentist is working.

      Of course, if this is not tolerable, anesthesiologists do take care of patients in need of dental work. This can range from some form of IV sedation and all the way to general anesthesia. But keep in mind that this would require you to get an IV, so the needle issue would present itself there as well.

      I hope this information has been helpful, and I wish you the best in taking care of that tooth extraction.

      Dr. Dave

  4. Emad Mohamed says:

    I am getting an MRI done tomorrow morning for my heart, and they may have to inject a contrast medium, this being done by IV most of the time. I have been told in the past I am an easy stick, but I’m still heavily terrifyed of any kinds of needles. When I was 18 months old, I had bleeding ulcers in my stomach, and was immediately rushed to the hospital. They could not find a good vein, so they stuck me 20+ times. Yes, you read that correctly, 20+ times. I don’t understand how I’m an easy stick nowadays and wasn’t then? Also can they give me the sedative before they inject the IV? Thank you!

    • David Draghinas says:

      Hi Emad,

      There’s a couple possible reasons you were a difficult IV stick back then. Infants often are a little chubby, hiding their veins. It’s also difficult to get an infant to hold still for IV placement. Finally, if you were bleeding from these ulcers you may have been hypovolemic, making IV placement that much more difficult.

      I hope you had a much better experience this time around. Please come back and let us know how it went.

      Dr Dave

  5. Brooke says:

    It took my doctors 7 times before they finally got the IV in just today…. Not the best first IV experience a person could have.

  6. Maranda says:

    Im getting my wisdom teeth out and the only thing I am nervous about the iv. What hurts the most? getting inserted in the hand or the middle of your arm?

  7. Jenna says:

    I need to have an endoscopy and colonoscopy. I cancelled twice because I was so terrified that I couldn’t sleep or function. I was abused by a doctor as a child with needles and I relive the trauma for months both before and even for years after so it is not over even when it is done. I did have an endoscopy 6 years ago and it was a bad experience for me. They refused to do anything that I requested to make it easier for me. What I requested was not unsafe but they said they were the boss and made fun of my fears. They would not listen to me that I am sensitive to anesthesia and pumped me full of drugs. I didn’t wake up for hours and then even after I got home, I couldn’t get up off the floor for the entire day. The rest of the week I was unable to eat, drive or think straight and lost 6 pounds. I had a virtual colonoscopy which was a piece of cake. I am absolutely terrified now and afraid of this endoscopy so much that I am becoming depressed

    • David Draghinas says:

      Hi Jenna,
      I’m sorry this procedure is creating so much stress and anxiety for you.

      A suggestion is to ask your endoscopist to put you in touch with the anesthesiologist that will be taking care of you.You can tell them all about your fears regarding anesthesia and this procedure. They will be able to come up with a reasonable and safe anesthesia plan for you.

      Dr Dave

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