10 New Anesthesia Technologies:
Are They Right for You
An except from the September 2003 issue
Of Outpatient Surgery Magazine

Can these technologies improve your facilitiy's efficiency, safety, and bottom line?

Bill Meltzer
Outpatient Surgery Magazine
September, 2003 injection.

To bring you an inside look at the newest anesthesia technologies, Outpatient Surgery asked a panel of anesthesiologists and CRNAs to weigh in on 10 of the latest advances. While there was no consensus on any of the devices, anesthesia providers weren't shy about sharing their enthusiasm, skepticism or complaints regarding the products in question. Here's a review of what they said about the technologies to help you decide whether to incorporate them in your facility.

Needle-free jet injectors
Jet injectors, which may resemble a toy gun and be as small as a pencil, deliver medications parenterally, without a needle, before the IV catheter touches the skin. Modern jet injectors blast compressed carbon dioxide to eject medication through a micro orifice at the injection site.

Technology proponents insist the devices eliminate much of the anxiety felt by needle-phobic patients, virtually
eliminate the pain associated with an injection or placement of the IV (reports on whether

the anxiety felt by needle-phobic patients, virtually
eliminate the pain associated with an injection or placement of the IV (reports on whether

Anesthesiologist Elemer Zsigmond, MD, a professor of anesthesiology emeritus at the University of Illinois at Chicago (UIC) has long championed needle-free jet injection and needle-free TIVA for children. He says that facilities make back the device costs (depending on the model, they can cost up to nearly $1 per injector, including the loaded syringe) in infection control savings alone. Jet injectors eliminate the costs of purchasing and disposing of the needle and needle container.

UIC's medical center abandoned conventional needle injections three years ago and now does jet injections in all areas of the hospital, from ambulatory surgery to the ER to oncology units that provide chemotherapy. Cedars-Sinai and Seattle Children's' Hospital have studied the UIC model and are switching to jet

Fear of pain in general and - needles in
particular - are a lot of patients' biggest worry about surgery, says UIC's Patrick Darby, RN, who has started thousands of IVs with jet injection.

"Ninety-nine times out of 100, patients find jet injection painless, although occasionally some say it's uncomfortable," he says.

"I've evaluated such products, and they're iffy at best," says Jeffrey Katz, MD, of Chicago. "They create a pinhole in the skin like any needle and they're not pain free. Some would argue that injecting sterile water is equally painless."

Dr. Zsigmond counters that at UIC, they've used jet injection on more than 120,000 patients, and the injections are painless and they shorten cases, because a painless, fast IV insertion shortens transfer time between pre-op and the OR. "Now that we routinely use jet-injected local anesthesia prior to IV catheter insertion, we've completely eliminated transfer delays, starting surgeries sooner," he says.