Lidocain

Titel: The Efficacy of Needle-free Injection System (INJEX®) in Relieving the Pain of Spinal Needle Insertion
Date: Aug 2011
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J Turk Anaesth Int Care 2010; 38(2):122-128
The Efficacy of Needle-free Injection System (INJEX®) in Relieving the Pain of Spinal Needle Insertion

 

Summary

 

Aim: INJEX® is a needle-free drug delivery system mainly developed for vaccination and insulin applications. It has been successfully used in various anesthesia procedures. This study was designed to compare the effects of local anesthesia application with INJEX®, a needle free injection system or with dental needle on relieving pain associated with spinal needle insertion and relevant patient satisfaction.
Material and Methods: Sixty patients scheduled for surgical operations under spinal anesthesia were randomly allocated to two groups. Prior to spinal anesthesia, spinal needle insertion area was infiltrated with 1.5 mL of 2 % lidocaine using 27 gauge dental needle in Group 1 and 0.3 mL, 2 % lidocaine by needle-free injection system (INJEX® model 210) in Group 2. Pain intensities during local anesthetic application and spinal needle insertion were assessed immediately after each procedure by visual analogue scale (VAS). Patient satisfaction in each group was also compared on a 4-point scale.
Results: Pain scores measured during local anesthesia administration were significantly lower in the INJEX® group than in the dental needle injection group (p=0.001). No significant difference was found between two groups as for pain scores during spinal needle insertion (p=0.382). Patient satisfaction was found to be higher with INJEX® with a limited significance (p=0,049).
Conclusion: INJEX® is an effective alternative to dental needle for lidocaine infiltration during the administration of spinal anesthesia with less pain and higher patient satisfaction.

 

 

BY: Hüseyin Sert, Bünyamin Muslu, Burhanettin Usta, Muhammet Gözdemir, Rüveyda İrem Demircioğlu
Fatih Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı

 

Titel: A novel needle-free powder lidocaine delivery system for rapid local analgesia
Date: Mär 2008
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A novel needle-free powder lidocaine delivery system for rapid local analgesia Zempsky WT, Robbins B, Richards PT, Leong MS, Schechter NL.  2008 Mar;152(3):405-11. Epub 2007 Oct 22.

Titel: Needle-Free Delivery of Lidocaine for Reducing the Pain Associated with the Fine-Needle Aspiration Biopsy of Thyroid Nodules
Date: Dez 2007
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Needle-Free Delivery of Lidocaine for Reducing the Pain Associated with the Fine-Needle Aspiration Biopsy of Thyroid Nodules: Time-Saving and Efficacious Procedure, Alptekin Gursoy, Derun Taner Ertugrul,.... Department of Endocrinology and Metabolism

Titel: Needle-free jet-injection with lidocaine
Date: Jan 2003
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96(1):215-9, table of contents.

A needle-free jet-injection system with lidocaine for peripheral intravenous cannula insertion: a randomized controlled trial with cost-effectiveness analysis.

Division of Anesthesiology, Department of APSIC (Anesthesiology, Pharmacology, and Surgical Intensive Care), Geneva University Hospitals, Switzerland. lysakowski.christopher@hcuge.ch - Comment in:

Abstract

Insertion of a peripheral IV cannula is a common, although painful, procedure. We tested the analgesic efficacy, adverse effects, and cost-effectiveness of a needle-free intradermal drug delivery system (Jet) with lidocaine for the insertion of an IV cannula (18-gauge; dorsum of hand). Four-hundred patients were randomly allocated to one of four groups: (a) no treatment, (b) Jet (J-Tip), National Medical Products Inc, CA; $3.0 per device) with 0.5 mL of saline, (3) Jet with 0.5 mL of lidocaine 1%, and (4) Jet with 0.5 mL of lidocaine 2%. Pain was evaluated using a numerical verbal scale (NVS 0-10). A NVS < or =3 was considered as acceptable in this context. Incremental cost-effectiveness ratios were calculated. Without treatment, 42.4% of patients had a NVS < or = 3, 39.3% with saline, 60.7% with 1% lidocaine (relative risk [RR] compared with no treatment, 0.70; 95% confidence interval [CI], 0.53-0.93), and 86.7% with 2% lidocaine (RR, 0.49; 95% CI, 0.38-0.62). Nineteen and one-half percent of patients had a NVS >3 because of Jet treatment, 13.5% had local hyperemia, and 16.9% had minor local bleeding. Of all Jet treatments, 10.5% were technical failures, and there were 17.6% cannula insertion failures (10.1% without treatment [RR, 1.74; 95% CI, 0.92-3.32]). Compared with no treatment, costs to generate one additional patient with a NVS < or =3 were $23 with lidocaine 1% and $10 with lidocaine 2%. On insertion of an IV cannula on the back of the hand, 58% of patients report at least moderate pain. Lidocaine-Jet is analgesic; there is dose-responsiveness. However, Jet treatment is not painless, and costs incurred to achieve one success compared with doing nothing are not negligible. IMPLICATIONS: Insertion of an IV cannula is painful. Four-hundred patients were randomly allocated to test the analgesic efficacy, adverse effects, and cost-effectiveness of the needle-free intradermal drug delivery system (J-Tip); Jet). Jet with lidocaine is effective, but its application is not painless. Costs to achieve one patient with no more than moderate pain (numerical verbal scale < or =3 of 10) on insertion of an IV cannula are $10.

PMID: 12505955 [PubMed - indexed for MEDLINE] 

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