As we all know, inhalation inductions should be a part of any anesthesia providers bag-o-tricks. Considering the alternative...sticking a hungry 3 year-old with a needle, i'd go with gas. Two alternatives on the market strive to make that painful iv start (or any needle stick) a thing of the past:
Zingo and Synera.
From the manufacturer's website:
Zingo™ is indicated to provide topical, local analgesia to reduce the pain associated with peripheral IV insertions or blood draws, in children three to 18 years of age. Zingo is aneasy-to-administer, single-use, needle-free system containing 0.5 mg sterile lidocaine powder. By using compressed gas to accelerate the lidocaine particles into the skin, Zingo provides a rapid onset of action, allowing intravenous line placement or venipuncture to begin one to three minutes after administration.
SYNERA topical patch has
significant advantages for your patients. SYNERA, the topical analgesic [lidocaine/tetracaine mix] patch for superficial venous access procedures, approved for kids 3 years of age and older, has an onset of action in as little as 20 minutes, self-warming facilitates drug-delivery, peel and stick patch with bandage like appearance.
Not sure of costs at this time but they both seem like interesting alternatives. It seems the Zingo onset time has real advantages over the EMLA/bioocclusive method I currently employ. The twenty minutes required for Synera seems a bit too similar to what we already have. I also wonder how well-received the mini-explosion on the hungry three year-old's arm would really be. Comments? Experiences?
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Sure - Zingo has a loud pop when activated, still hurts a bit, scares the kids and only gives me a quarter sized area of anesthetized skin. Synera while taking 20 minutes was easy to use, didn't scare the kids and gives a much larger area of anesthesia. Oh, and the vein tends to pop pretty well due the heat.
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