Needle-Free Injection of Lidocaine for Local Anesthesia Prior to Trigger Digit Injection

NCT ID: NCT02084706

Last Updated: 2016-12-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2015-06-30

Brief Summary

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Jet-injection (J-tip) is a rapid, minimally invasive delivery system that can be used for the subdermal injection of lidocaine solution for anesthetic purposes. The device has been found effective in pain reduction during IV catheterization in adults and children and lumbar puncture in children when compared to placebo saline-jet injection. \[1-4\].

We believe that administering local anesthetic via J-tip prior to triamcinolone(40 mg/ml) injection could mitigate pain that occurs during and immediately following injection while preserving the post-injection pain relief of anesthetic injection. Furthermore, pre-placement of the jet-injected local anesthetic may obviate the need for the inclusion of local anesthetic into the triamcinolone injection. This would decrease the amount of fluid injected, which could have positive pain modulation by decreased tissue disruption.

Objective: To evaluate the effectiveness of needle free jet injection (J-tip) administration of 2% lidocaine in reduction of the pain experienced during trigger digit 40 mg/ml triamcinolone injection.

Hypothesis: Needle free jet injection (J-tip) administration of 2% lidocaine will prove an equal or superior means of pain reduction when compared to 2% lidocaine injection in the setting of trigger digit triamcinolone injections.

Detailed Description

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Conditions

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Trigger Finger

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

SINGLE

Participants

Study Groups

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Triamcinolone (20 g) and 2% Lidocaine injection over A1 pulley

Group one subjects will receive an injection of 0.5mL (20 g) of Triamcinolone and 0.5 mL of 2% Lidocaine over the A1 pulley.

Group Type ACTIVE_COMPARATOR

Triamcinolone (20 g) and 2% Lidocaine injection over the A1 pulley

Intervention Type PROCEDURE

2% Lidocaine

Intervention Type DRUG

Triamcinolone (20 g)

Intervention Type DRUG

J-tip lidocaine administration, then steroid injection

Group two subjects will receive a needle free "J-tip" administration of 0.5mL of 2% lidocaine prior (2-10 minutes) to needle injection of 0.5mL of Triamcinolone (20 g) over the A1 pulley.

Group Type EXPERIMENTAL

2% Lidocaine

Intervention Type DRUG

Triamcinolone (20 g)

Intervention Type DRUG

J-tip lidocaine administration

Intervention Type PROCEDURE

Triamcinolone (20 g) Injection over the A1 pulley.

Intervention Type PROCEDURE

Interventions

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Triamcinolone (20 g) and 2% Lidocaine injection over the A1 pulley

Intervention Type PROCEDURE

2% Lidocaine

Intervention Type DRUG

Triamcinolone (20 g)

Intervention Type DRUG

J-tip lidocaine administration

Intervention Type PROCEDURE

Triamcinolone (20 g) Injection over the A1 pulley.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients who present to the Hand Clinic at Brigham and Women's Hospital or Brigham and Women's Faulkner Hospital, are 18 years of age or older and are indicated for a trigger digit steroid injection will be eligible for participation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Philip Blazar, MD

Associate Professor, Harvard Medical School

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Philip E Blazar, MD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Lysakowski C, Dumont L, Tramer MR, Tassonyi E. A needle-free jet-injection system with lidocaine for peripheral intravenous cannula insertion: a randomized controlled trial with cost-effectiveness analysis. Anesth Analg. 2003 Jan;96(1):215-9, table of contents. doi: 10.1097/00000539-200301000-00044.

Reference Type BACKGROUND
PMID: 12505955 (View on PubMed)

Ferayorni A, Yniguez R, Bryson M, Bulloch B. Needle-free jet injection of lidocaine for local anesthesia during lumbar puncture: a randomized controlled trial. Pediatr Emerg Care. 2012 Jul;28(7):687-90. doi: 10.1097/PEC.0b013e31825d210b.

Reference Type BACKGROUND
PMID: 22743744 (View on PubMed)

Jimenez N, Bradford H, Seidel KD, Sousa M, Lynn AM. A comparison of a needle-free injection system for local anesthesia versus EMLA for intravenous catheter insertion in the pediatric patient. Anesth Analg. 2006 Feb;102(2):411-4. doi: 10.1213/01.ane.0000194293.10549.62.

Reference Type BACKGROUND
PMID: 16428534 (View on PubMed)

Spanos S, Booth R, Koenig H, Sikes K, Gracely E, Kim IK. Jet Injection of 1% buffered lidocaine versus topical ELA-Max for anesthesia before peripheral intravenous catheterization in children: a randomized controlled trial. Pediatr Emerg Care. 2008 Aug;24(8):511-5. doi: 10.1097/PEC.0b013e31816a8d5b.

Reference Type BACKGROUND
PMID: 18645542 (View on PubMed)

Kolind-Sorensen V. Treatment of trigger fingers. Acta Orthop Scand. 1970;41(4):428-32. doi: 10.3109/17453677008991530. No abstract available.

Reference Type BACKGROUND
PMID: 5537268 (View on PubMed)

Lapidus PW, Guidotti FP. Stenosing tenovaginitis of the wrist and fingers. Clin Orthop Relat Res. 1972 Mar-Apr;83:87-90. doi: 10.1097/00003086-197203000-00015. No abstract available.

Reference Type BACKGROUND
PMID: 5014835 (View on PubMed)

Rhoades CE, Gelberman RH, Manjarris JF. Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting. Clin Orthop Relat Res. 1984 Nov;(190):236-8.

Reference Type BACKGROUND
PMID: 6488636 (View on PubMed)

Murphy D, Failla JM, Koniuch MP. Steroid versus placebo injection for trigger finger. J Hand Surg Am. 1995 Jul;20(4):628-31. doi: 10.1016/S0363-5023(05)80280-1.

Reference Type BACKGROUND
PMID: 7594291 (View on PubMed)

Other Identifiers

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2013P002370

Identifier Type: -

Identifier Source: org_study_id