Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial

<h4>Background</h4> Peripheral venous cannulation is one of the most common procedures in medicine. It is associated with noticeable pain and apprehension, although in most cases it is performed without any anesthesia due to lack of a painless, cost-effective option, which would provide...

Full description

Bibliographic Details
Main Authors: Alexey Rzhevskiy, Andrei Popov, Chavdar Pavlov, Yuri Anissimov, Andrei Zvyagin, Yotam Levin, Efrat Kochba
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803196/?tool=EBI
_version_ 1818083838398562304
author Alexey Rzhevskiy
Andrei Popov
Chavdar Pavlov
Yuri Anissimov
Andrei Zvyagin
Yotam Levin
Efrat Kochba
author_facet Alexey Rzhevskiy
Andrei Popov
Chavdar Pavlov
Yuri Anissimov
Andrei Zvyagin
Yotam Levin
Efrat Kochba
author_sort Alexey Rzhevskiy
collection DOAJ
description <h4>Background</h4> Peripheral venous cannulation is one of the most common procedures in medicine. It is associated with noticeable pain and apprehension, although in most cases it is performed without any anesthesia due to lack of a painless, cost-effective option, which would provide rapid local anesthesia with subsequent significant reduction in the experienced pain. We conducted an open-label placebo-controlled clinical trial to evaluate the efficacy and safety of a 2% lidocaine injection using the commercially available microneedle device MinronJet600 (NanoPass Technologies Ltd, Israel) to achieve rapid local anesthesia prior to peripheral venous cannulation. <h4>Methods</h4> One hundred and two subjects were randomly allocated into two groups. In the first group, 100μL of lidocaine hydrochloride (2%) was injected intradermally to subjects using the MicronJet600 device in the left arm (MJ-Lido) and 100μL of saline was injected intradermally using the device in the right arm (MJ-Saline). In the second group, 100μL of lidocaine hydrochloride (2%) was injected using the MicronJet600 device into the left arm (MJ-Lido), with no injection into the right arm of subjects (No pretreatment). In both groups the intradermal injection was performed at the cannulation site prior to insertion of a 18G cannula into a median cubital vein in both arms. As a primary variable, a score of cannulation-induced pain was indicated by subjects using a 100-point visual analog scale immediately after cannulation. As a secondary variable, subjects in Group 2 also indicated their preference to receive the anaesthetic injection with MicronJet600 in the future by using the 5-point Likert scale. Also, as a secondary variable, the duration of skin numbness after lidocaine injection was indicated by performing a superficial pin-prick with a 27G needle at 15, 30 and 45 minutes, at distances of 1, 2 and 3 centimeters from the injection site. <h4>Results</h4> A significant pain reduction (11.0-fold) was achieved due to the lidocaine injection compared to the cannulation without any pretreatment (p< 0.005). After the lidocaine injection the anesthesia was effective up to 2 centimeters from the injection site and remained for up to 30 minutes. Eighty percent of subjects from the second group preferred cannulation after the lidocaine injection over cannulation without any pretreatment. No significant side effects were identified. <h4>Conclusion</h4> Intradermal injection of anaesthetic with Micronjet600 was found to be a safe and effective option for providing rapid local anesthesia for peripheral intravenous cannulation. <h4>Trial regiatration</h4> The clinical trial was registered, before the patient enrollment began, in the Research Registry publicly accessible database (registration identifier: researchregistry4662). Also, the trial was registered in ClinicalTrials.gov (registration identifier: NCT05108714) after its completion.
first_indexed 2024-12-10T19:44:21Z
format Article
id doaj.art-738ddc2337d4422db81aaee49e823753
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-10T19:44:21Z
publishDate 2022-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-738ddc2337d4422db81aaee49e8237532022-12-22T01:35:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01171Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trialAlexey RzhevskiyAndrei PopovChavdar PavlovYuri AnissimovAndrei ZvyaginYotam LevinEfrat Kochba<h4>Background</h4> Peripheral venous cannulation is one of the most common procedures in medicine. It is associated with noticeable pain and apprehension, although in most cases it is performed without any anesthesia due to lack of a painless, cost-effective option, which would provide rapid local anesthesia with subsequent significant reduction in the experienced pain. We conducted an open-label placebo-controlled clinical trial to evaluate the efficacy and safety of a 2% lidocaine injection using the commercially available microneedle device MinronJet600 (NanoPass Technologies Ltd, Israel) to achieve rapid local anesthesia prior to peripheral venous cannulation. <h4>Methods</h4> One hundred and two subjects were randomly allocated into two groups. In the first group, 100μL of lidocaine hydrochloride (2%) was injected intradermally to subjects using the MicronJet600 device in the left arm (MJ-Lido) and 100μL of saline was injected intradermally using the device in the right arm (MJ-Saline). In the second group, 100μL of lidocaine hydrochloride (2%) was injected using the MicronJet600 device into the left arm (MJ-Lido), with no injection into the right arm of subjects (No pretreatment). In both groups the intradermal injection was performed at the cannulation site prior to insertion of a 18G cannula into a median cubital vein in both arms. As a primary variable, a score of cannulation-induced pain was indicated by subjects using a 100-point visual analog scale immediately after cannulation. As a secondary variable, subjects in Group 2 also indicated their preference to receive the anaesthetic injection with MicronJet600 in the future by using the 5-point Likert scale. Also, as a secondary variable, the duration of skin numbness after lidocaine injection was indicated by performing a superficial pin-prick with a 27G needle at 15, 30 and 45 minutes, at distances of 1, 2 and 3 centimeters from the injection site. <h4>Results</h4> A significant pain reduction (11.0-fold) was achieved due to the lidocaine injection compared to the cannulation without any pretreatment (p< 0.005). After the lidocaine injection the anesthesia was effective up to 2 centimeters from the injection site and remained for up to 30 minutes. Eighty percent of subjects from the second group preferred cannulation after the lidocaine injection over cannulation without any pretreatment. No significant side effects were identified. <h4>Conclusion</h4> Intradermal injection of anaesthetic with Micronjet600 was found to be a safe and effective option for providing rapid local anesthesia for peripheral intravenous cannulation. <h4>Trial regiatration</h4> The clinical trial was registered, before the patient enrollment began, in the Research Registry publicly accessible database (registration identifier: researchregistry4662). Also, the trial was registered in ClinicalTrials.gov (registration identifier: NCT05108714) after its completion.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803196/?tool=EBI
spellingShingle Alexey Rzhevskiy
Andrei Popov
Chavdar Pavlov
Yuri Anissimov
Andrei Zvyagin
Yotam Levin
Efrat Kochba
Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
PLoS ONE
title Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
title_full Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
title_fullStr Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
title_full_unstemmed Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
title_short Intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation: A randomised open-label placebo-controlled clinical trial
title_sort intradermal injection of lidocaine with a microneedle device to provide rapid local anaesthesia for peripheral intravenous cannulation a randomised open label placebo controlled clinical trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803196/?tool=EBI
work_keys_str_mv AT alexeyrzhevskiy intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT andreipopov intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT chavdarpavlov intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT yurianissimov intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT andreizvyagin intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT yotamlevin intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial
AT efratkochba intradermalinjectionoflidocainewithamicroneedledevicetoproviderapidlocalanaesthesiaforperipheralintravenouscannulationarandomisedopenlabelplacebocontrolledclinicaltrial