1 of Table 7
Synthesis Table -: J-tip
Practice Area: Drugs and Devices for Needlesticks/Procedures: J-Tip
Topic
J-Tip – a
needleless
injection
system
Citation
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;102:411-4
Sample
116 Children
7-19 yrs
RCT
Key Findings
More time from application to IV
start with EMLA
J-Tip had lower pain scores
Both treatment groups had similar
outcomes with success on first
attempt. J-Tip – decrease
vasoconstriction. EMLA not
always on for 60 mins.
(carbon dioxide gas cartridge
drives plunger down the barrel of
the syringe, expelling medication
through a micro-orifice.
Penetrates the skin surface and
subQ tissue to a depth of 5-8 mm
in 0.2s
84% reported no pain with J-Tip
Compared with 64% with EMLA
J-Tip – a
needleless
injection
system
Spanos, S, Booth, R, Koenigh et al
Jet Injection of 1% Buffered Lidocaine
versus Topical ELA-Max for
Anesthesia Before peripheral
Intravenous Catheterization in
Children
Pediatric Emergency Care 2008,
24(8) : 511-515
75 Children
8-15 yrs
30 minute ELA-Max
J-tip 1% Lidocaine
Pain with j-tip
Pain with IV start
Video-taped
J-Tip less pain
CRT
Nurses who started IV- reported
less pain in the J-tip grop
Blinded observers scores for pain
were less for J-tip
Comments
Pediatric patients have
thicker subcutaneous
tissue-deeper
penetration of local anes
Ref: Fine, B found that
children younger than
7 seemed more
disturbed by j-Tip
Fast, absence of
vasoconstriction
J-Tip is a needless Food
and Drug Adm injection
system.
J-Tip app with 1%
buffered lido is not
painful and had better
anesthetic effect
compared with EMLA
Cost = ?
Anesthesia in 5 minutes
with j-tip
No follow-up for
complications with Jtip ( ? can scar)
2 of Table 7
J-Tip – a
needleless
injection
system
Cooper, JA, Bromley, LM,
Baranowski, AP, & Barker SGE
Evaluation of a needle-free injection
system for local anaesthesia prior to
venous cannulation
Anaesthesia 200 55: 247-250
UK study
72 patients
Adults over 18 yrs
Prior to
anesthesia
J-tip or with a 25
G needle/syring
Pain of treatment
and pain of
starting IV
Less pain with J-tip delivery than
needles but more pain with
cannulation
No difference in number of failed
cannulations- but clinicians felt it
was hard with lidocaine.
RCT
J-Tip – a
needleless
injection
system
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.
Anesthesia & Analgesia 2003: 96:
215-219
Swiss study
14-88yrs
4 groups;
No treatmentsimulated sound
Jet with saline
Jet with 1%
Jet with 2%
400 patients
RCT
Pt received midazolam orally
prior to procedure
Jet with lidocaine decreased pain.
2% reduced pain scores by 50%
1/5 of patients reported moderate
pain from the jet delivery
Device failure in 1/10 of
application
J-tip gives wide
distribution
Difficult delivery in thin
patients with less subQ
tissue. Original use was
for insultin-administered
in abdomen or thigh
which has more subQ
tissue than hard or hand.
J-Tip 1.80 pounds and 2
ml syringewas 0.01
pounds
Estimated cost for
lidocaine jet was $4.1 $4.2. Incremental; costeffectiveness
ration(ICER) was $10$11 for