Needle-Free Injection of Lidocaine for Local Anesthesia Prior to Trigger Digit Injection (J-tip)

Mass General Brigham

Status: Completed

Conditions: Trigger Finger

Treatments: Procedure: Triamcinolone (20 g) Injection over the A1 pulley.; Procedure: Triamcinolone (20 g) and 2% Lidocaine injection over the A1 pulley; Drug: 2% Lidocaine; Procedure: J-tip lidocaine administration; Drug: Triamcinolone (20 g)

Study type: Interventional

Funder types: Other

Identifiers

NCT02084706

2013P002370

Details and patient eligibility

About

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.

Enrollment: 60 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

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

Trial design

60 participants in 2 patient groups

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

Active Comparator group

Description:

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.

Treatment:

Drug: Triamcinolone (20 g)

Drug: 2% Lidocaine

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

J-tip lidocaine administration, then steroid injection

Experimental group

Description:

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.

Treatment:

Drug: Triamcinolone (20 g)

Drug: 2% Lidocaine

Procedure: J-tip lidocaine administration

Procedure: Triamcinolone (20 g) Injection over the A1 pulley.