A Comparison of a Needle-Free Injection System for Local Anesthesia Versus EMLA(R) for Intravenous Catheter Insertion in the Pediatric Patient.
Jimenez, Nathalia MD; Bradford, Heidi BA; Seidel, Kristy D. MS; Sousa, Manuela MD; Lynn, Anne M. MD
Anesthesia & Analgesia.
102(2):411-414, February 2006.
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Placement of IV catheters is a painful and stressful procedure for children. J-Tip(R) is a needle-less Food and Drug Administration approved injection system that can be used for delivery of local anesthetic before IV cannulation. In this study, we compared the effectiveness of J-Tip(R) versus eutectic mixture of local anesthetics (EMLA(R)) to facilitate IV cannulation and provide adequate analgesia before IV placement. Children 7-19 years of age (n = 116) were randomized to receive 0.25 mL of 1% buffered lidocaine with J-Tip(R) (n = 57) or 2.5 g of EMLA(R) (n = 59) before IV cannulation. Measurements of success of cannulation (number of attempts for IV placement) and pain (0-10 visual analog scale) at application of local anesthetic and at cannulation were performed. There was a significant (P = 0.0001) difference in pain ratings during IV cannulation between EMLA(R) (median = 3) and the J-Tip(R) (median = 0). Eighty-four percent of patients reported no pain at the time of J-Tip(R) lidocaine application compared to 61% in the EMLA(R) group at the time of dressing removal (P = 0.004). We did not find differences in the number of attempts for IV cannulation. J-Tip(R) application of 1% buffered lidocaine before IV cannulation is not painful and has better anesthetic effectiveness compared with EMLA(R).
(C) 2006 International Anesthesia Research Society