ABSTRACT
BACKGROUND: Though a needleless jet injection device (NJI device) has advantages over a conventional needle attached syringe for injecting anesthetics, safety of using it for lid surgery is not proved. We report a case of posterior segment injury suspected caused by a NJI device. METHODS: A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device. RESULTS: Vitreous and subretinal hemorrhage was found associated with retinal edema adjacent to the optic disc of the right eye and around the inferior temporal arcade of the left eye. Fluorescein angiography revealed choroidal rupture in the both eyes. By 2 months, although the hemorrhage resolved, subretinal fibrosis and chorioretinal atrophy developed. Her vision decreased to 20/60 in the right eye and 20/40 in the left eye. CONCLUSION: The energy generated by the NJI device seemed to have reached the eyeballs to cause the blunt-typed posterior segment injuries. As choroidal rupture may result in a permanent visual loss, the risks associated the off-labeled use of the device for lid surgeries should be awakened.
Subject(s)
Anesthesia, Local/instrumentation , Choroid/injuries , Eye Injuries/etiology , Injections, Jet/adverse effects , Wounds, Nonpenetrating/etiology , Anesthetics, Local/administration & dosage , Eye Injuries/diagnosis , Eyelids/drug effects , Female , Fluorescein Angiography , Humans , Middle Aged , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/etiology , Rupture , Vision Disorders/diagnosis , Vision Disorders/etiology , Vitreous Hemorrhage/diagnosis , Vitreous Hemorrhage/etiology , Wounds, Nonpenetrating/diagnosisABSTRACT
UNLABELLED: Local anesthesia is one of the basic and the most often executed interventions in dentistry. This procedure is very stressful for the patients because it is combined with pain. The new systems for delivering local anesthesia in dentistry have revolutionized the technique considerably by its simplify as well as reduction in pain. THE AIM: this study presents the comparison between the local anesthesia delivery systems used in dentistry--The Wand and Injex, taking into consideration pain intensity during performing anesthesia and the intensification of fear before executed anesthesia with the given system. MATERIAL AND METHODS: the Visual Analogue Scale (VAS), verbal scale and questionnaires were used to evaluate pain and fear. RESULTS: On the basis of our investigations it can be concluded that there were statistically important differences between men and women in fear intensity combined with the anesthesia procedure--men were less afraid than women. The patients who were anaesthetized with system The WAND declared less fear before similar anesthesia in future. The average value of intensity of pain analyzed with both verbal and visual scales during anaesthetizing with the system Injex (independently from sex) was statistically significantly higher than for system The WAND--respectively 0.57 and 8.55 for The WAND, 2.02 and 32.18 for Injex (p = 0.001). CONCLUSION: on the basis of the results of this study it can be concluded that the less stressful and painful local anesthesia delivery system is the WAND.
Subject(s)
Anesthesia, Dental/methods , Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Dental Anxiety/prevention & control , Facial Pain/prevention & control , Adult , Anesthesia, Dental/instrumentation , Anesthesia, Local/instrumentation , Benzocaine/administration & dosage , Equipment Design , Female , Humans , Injections, Intradermal/adverse effects , Injections, Intradermal/instrumentation , Injections, Jet/adverse effects , Injections, Jet/instrumentation , Lidocaine/administration & dosage , Male , Needles/adverse effects , Pain Measurement/methods , Patient SatisfactionABSTRACT
The clinical safety, use and pharmacokinetics of a new needle-free device for delivery of growth hormone (GH) were compared with those of conventional needle injection devices. In an open-label, randomized, 4-period crossover study, 18 healthy adults received single subcutaneous injections of Genotropin administered by the Genotropin ZipTip needle-free device and by conventional injection. Bioequivalence was established between the devices. In a separate open-label, randomized, multicenter, 2-period crossover study, pediatric patients underwent 2-weeks Genotropin treatment administered by the Genotropin ZipTip and by a fine-gauge needle device (>95% used the Genotropin Pen). In total, 128/133 patients who were treated completed the study. Genotropin ZipTip was well tolerated and >50% of patients found no difference between the devices for all parameters assessed. After study completion, >20% patients preferred to continue using Genotropin ZipTip. Although statistical analyses demonstrated superiority of the Genotropin Pen versus Genotropin ZipTip for bleeding, pain, soreness, and bruising, Genotropin ZipTip was considered to provide a safe and bioequivalent alternative to needle injection.