Needle-free anaesthesia, a promising option for the needle-phobic patient

Abstract

Funding sources: None. Conflicts of interest: None declared. Dear Editor, Needle phobia and pain during injection with a needle is often an overlooked obstacle that may impede access to effective healthcare in dermatological procedures. Needle phobia, defined as an intense, persistent and unreasonable fear of needles, affects more than 20% of the population. Needle injection on the thick skins of the palms requires an effective pain management method, particularly during onabotulinumtoxinA (BTX‐A) injections to control intractable palmar hyperhidrosis.1 Peripheral nerve blockade of the wrist, an effective method of alleviating pain during palmar injection may have serious drawbacks, particularly when used repeatedly.2 Moreover, it is time consuming and may affect hand dexterity for many hours. The Bier block technique is also effective, but systemic effects could occur.3 Vibration anaesthesia has been used with inconsistent results.4 Cryoanalgesia can freeze the needle, slowing down the diffusion of the injectate.5 Needle‐free injection, also known as jet injection, is a needle‐free drug delivery method in which a high‐speed stream of fluid penetrates the skin. The use of jet injectors in routine dermatological practice remains low owing to several factors, including the risk of infection, pain and bruising. In our practice, a versatile, low‐pressure needle‐free injector (such as the Med‐Jet® MBX manufactured by MIT Canada, Montreal, QC, Canada) has many applications. Here we describe two cases that illustrate the effective application of a needle‐free injection device for local anaesthesia.