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A colleague is keen to find out the views of subscribers to injectionless anaesthesia such as Biojet. He is especially interested in experiences relating to nailwork.

TIA

Cameron

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Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

Hi Cameron,
Would this be the same/similar to the Panjet ?

I had one of these years ago. Similar to the needleless system used by Dr McCoy (?) on Startrek, with one important difference.
The standard model was capable of raising a wheal, nothing more. The more powerful Veterinary model delivered a higher dose of chosen anaesthetic - IMO imprecisely.
Also it hurt !

Again, IMO - nothing currently beats good technique and a needle for precise and painless injections.

Regards,
davidh

Similar experience as David's but in addition, a substantial number of patients had moderate to severe contusion and haematoma at infiltration site. These were/are being marketed for patients who have needle phobias, but a good technique with 30g short dental needle is measurably less painful than high pressure infiltration.

__________________
"citing an indisposition due to special circumstances"

My location

Many thanks for your replies and I will pass them on.

Cameron


Polillio AM, Kiley J. Does a needleless injection system reduce anxiety in children receiving intramuscular injections? Pediatr Nurs. 1997 Jan-Feb;23(1):46-9. Related Articles, Links

Previous studies have shown that needle injections are very stressful for children. This study examined if a needleless injection system would be associated with lower anxiety levels in children by comparing children's responses to a traditional needle injection to their responses to the Biojector, a needleless system. Seventy-four sixth-grade students of two public middle schools, all scheduled to receive the Hepatitis B vaccine, were enrolled. The study used a cross-over design. The children's anxiety levels were measured both before and after each of the two types of injections using the Spielberger State Trait Anxiety Index for Children (STAIC). Data analysis found no significant difference in levels of anxiety associated with the Biojector injections when compared with anxiety levels associated with needle injections. When asked to choose the injection method for their third injection, however, students showed a preference for the Biojector (61%), which indicated a trend towards significance (p = .08).

Sundry information
http://www.pdmhealthcare.com/communique1005/needles.htm
http://www.gizmodo.com/archives/life...ion-022206.php
http://www.usmedicine.com/dailyNews.cfm?dailyID=259
http://www.prnewswire.com/cgi-bin/st...0683778&EDATE=
http://www.robbinsinstruments.com/de...mojethome.html
http://scholar.lib.vt.edu/VA-news/VA...9/01270064.htm

__________________

Cameron Kippen, Podologist and Shoe Historian




Cameron Kippen

Hi Cameron,
I recently enquired via private message to another Pod. (in USA) I was intrigued RE: painless needle free solutions. His practice use the 'Madajet'' tm system. He expressed he has success with the system but utilises it mainly for pre injection analgesia of localised injection site. I tried to follow link via web to 'Madajet' supplier. I found their site no problem but alas still await a reply from them to my email RE: more information/ studies etc.

Must admit though I still find it's the 17stone rugger players who cry the most though.

It's the 7stone lil ole ladies in for ankle blocks just take a deeeeep breath n seem ok.

Boys eh!

Regards,

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:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

Thanks for trying Twirly, much appreciated.

C

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My location

Hi

Twas probably me you refered to and I am Canadian NOT American, watch yor language buster

I can't remember exactly what I replied to you and had not examined this thread before.

I just wanted to emphasise that in my experience the Madajet is cabable in most people of allowing infiltration of plantar lesions and then performing painless hyfrecation of superficial lesions such as warts, and very useful for preparing medial heel area prior to infiltation into Pfascia which is pretty brutal if done without this and it is much faster than doing a tibial nerve block.

It would be a missed opportunity to regard this as some gimmiky toy, if used appropriately I find it very useful but with expected limitations.

Like most things technique is important. Here's some suggetsions

To get good penetration make sure that jet is perpendicular to skin and skin is taut otherwise the infiltrate will bounce off the surface. Fire in several shots, the first will create pain similar to horsefly bite on thick plantar skin barely and barely perceptible on dorsal surfaces. Second shot is usually painless instantly if first worked and 3 is usually sufficient for 6mm dia lesion.

Use epinephrine in LA to reduce bleeding especially for vascular lesions. This also reduces precipitation inside device for some reason presumably because of pH difference.

Do not bother trying to do nerve block with this penetration is inadequate. When using electrosurgery, gradually increase power so that if inadequate anesthesia pain will be slight tingling rather than lightenning stike.

Be aware that this does cause some damage usually bruising, it may be a little uncomfortable for 24 hrs because of this.

I would not use this with someone with atrophic skin, or close to infection for obvious reasons.

The whole device is autoclavable between filling and the tips are detatchable and likewise autoclavable, beats me why the company advocates cold disinfection, I think this would be inadvisable.

A colleague of mine recently asked me about depth of penetration with this, we are going to get together tomorrow and try a couple of different sites and see if we can measure this with high res US. I'll post results if this works


cheers

Martin


a CANADIAN and proud of it . . . . . . . . well you know a little bit not really in a brash sort of way, infact I shouldn't of mentioned it really because we dont really talk about it much unless asked or ......... unless of course we beat those AMERICANS at HOCKEY, or soccer(football), swimming, running, spelling Bs (watch Spellbound) wheelchair Basketball (watch murderball another great Canadian Film) tiddley winks or just about anything because . . . . . it doesnt happen very often :(



The St. James Foot Clinic
1749 Portage Ave.
Winnipeg
Manitoba
R3J 0E6
phone [204] 837 FOOT (3668)
fax [204] 774 9918
www.winnipegfootclinic.com

Thanks Mart,
Indeed twas your good self.
Am mortified to have offended one RE: (USA Vs Canada) thingy!

I know the feelings my friend. My mother is still at war with the French. ''They won't buy our lamb''. ''We won't buy their bleedin apples!''

Oldies always seem to have difficulty forgetting a grudge. :p

Tee Hee

Thanks again.

Regards

__________________
:)
twirly

Mandy Brooks
Brooks Podiatry
S64 0DE

Suffering a fondness for odd things.

Hi Twirly

I didn't get time to do a thorough exploration of madajet penetration, but to pique your curiousity I did infiltrate the back of my arm with a single 0.1ml dose and have a peek with US as I was about to leave.

I was suprised how deep the infiltrate seemed to go. It is possible that the hypoechoic (darkened) regeon in the attatched image represents a haematoma, but I think it more likely a mixture of blood and LA.

It has kind of piqued my interest a bit and if I find time next week I'll see what happens on plantar calcaneal area and plantar metatarsal area, also will see if I can capture video of how fluid spreads although I doubt the US will sample images fast enough to capture such an instantaneous event

cheers

Martin



The St. James Foot Clinic
1749 Portage Ave.
Winnipeg
Manitoba
R3J 0E6
phone [204] 837 FOOT (3668)
fax [204] 774 9918
www.winnipegfootclinic.com

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