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NRFit: Eliminating Missed Connections
NRFit is a new type of medical connector used for neuraxial and major regional anesthesia applications and is defined by ISO 80369-6. NRFit intends to increase patient safety by eliminating wrong route connections between patient supply lines that administer a variety of medications, nutrition, and other lifesaving fluids. Currently the universally compatible connector for all these supply lines is called a Luer connector, which has been identified as one of the main reasons for medication errors due to wrong route injections.
As the leading manufacturer in Regional Anesthesia, PAJUNK® offers its entire product portfolio for Neuraxial, major Regional Anesthesia, Wound Infiltration well as Lumbar Puncture applications in accordance with ISO 80369-6.
Increased patient safety due to optimal vizualisation under ultrasound: Pajunk’s Cornerstone Reflectors
Pajunk’s patented Cornerstone reflectors (three-dimensional pyramid-like embossing along the first 20mm of the needle) make the needle shaft much easier to see and allow for optimized needle vizualization at any angle under ultrasound.1,2,3 They are key to the echogenicity of many Pajunk products.
Several independent studies have confirmed: SonoPlex® has revolutionized the Ultrasound Guided Puncture.
Find Echogenic Pajunk Products
1 FuzierR. et al. The echogenicity of nerve blockade needles, Anesth.2015; 70: 462–466
2 Uppal V. et al. Effect of beam steering on the visibility of echogenic and non-echogenic needles: a laboratory study, Can. J. Anesth. 2014 Oct; 61(10): 909–915
3 Hebard S., Hocking G. Echogenic technology can improve needle visibility during ultrasound-guided regional anesthesia, Reg. Anesth. Pain Med. 2011 March–April; 36(2): 185–189
Reducing Risk of Nerve Damage with NerveGuard
Ultrasound-guided localization of peripheral nerves and the associated real-time visualization provide crucial benefits in regional anesthesia.1 Nonetheless, it is clear that this does not eliminate the incidence of permanent nerve damage.2 Even in combination with nerve stimulation, intrafascicular injections cannot be ruled out.1,3,4,5
The causes include incorrect positioning of the needle along with exceeding critical injection pressures. With the NerveGuard, developed by Pajunk, the injection pressure is automatically limited to decrease the risk nerve damage.
1 Choquet O., Capdevila X. Ultrasound-guided nerve blocks: the real position of the needle should be defined, Anaesth. Analg. 2012 May; 114(5): 929–930
2Neil J. M., Brull R., Horn J. L., Liu S. S., McCartney C. J., Perlas A., Salinas F. V., Tsui B. C. The Second American Society of Regional Anesthesia and Pain Medicine Evidence-Based Medicine Assessment of Ultrasound-Guided Regional Anesthesia, Reg. Anaesth. Pain Med. 2016 March–April; 41(2):181–194
3Robards C., Hadzic A., Somasundaram L., Iwata T., Gadsden J., Xu D., Sala-Blanch X. Intraneural injection with low-current stimulation during popliteal sciatic nerve block, Anesth. 2009 Aug; 109(2): 673–677
4Sites B. D., Spence B. C., Gallagher J. D., Wiley C. W., Bertrand M. L., Blike G. T. Characterizing novice behavior associated with learning ultrasound-guided peripheral regional anesthesia, Reg. Anesth. Pain Med. 2007 Mar–Apr; 32(2):107–115
5Kapur E., Vuckovic I., Dilberovic F., Zaciragic A., Cosovic E., Divanovic K. A., Mornjakovic Z., Babic M., Borgeat A., Thys D. M., Hadzic A. Neurologic and histologic outcom eafter intraneural injections of lidocaine in canine sciatic nerves, Acta. Anaesthesiol. Scand. 2007 Jan; 51(1): 101–107
EpiLong VPC for Visual Indication of Loss of Resistance (LOR)
There are different ways to find the epidural space including hanging drop and loss of resistance. These are associated with various risks, which makes it difficult to find.
The EpiLong VPC offers a visual indication of Loss of Resistance during epidural procedures. The EpiLong VPC is a reliable alternative to the conventional LOR technique, by visually indicating even the smallest pressure change resulting in a more objective needle tip placement and increased patient safety.
Catheter over Needle (CON) technique reduces the risk of leakage and minimizes catheter dislocation
Dr. Ban Tsui with Pajunk developed E-Cath and E-Cath Plus to address the complex challenges of Continuous Nerve Blocks (CNBs): catheter kinking, leakage, migration and dislocation. The E-Cath uses new Catheter-Over-Needle technology and requires the same skillset as performing a single shot block.
It is faster, safer and enables more reliable continuous nerve blocks with a reduction of workload during postoperative pain management.
Reduce the risk of PLPH during Lumbar Puncture
For decades clinicians performing lumbar punctures had to battle the issues of Post Lumbar Puncture Headache (PLPH). One risk factor for post-lumbar puncture headaches is the use of a Quincke needle.6 With the introduction of the atraumatic Sprotte needle, the PLPH rates have been significantly reduced to allow for safer punctures and happier patients.
Sprotte Lumbar Advantages:
•Increases application safety
•Minimizes chance of PLPH 1, 2, 4, 5, 6, 7, 8
•Allows for quicker and optimized CSF flashback9
•Allows rapid detection of even the smallest quantities of CSF
•Minimizes chance of tissue coring
•Increases efficiency, reduces process and treatment costs 10
1 Davis, A.; Dobson, R.; Kaninia,S.; Giovannoni, G.; Schmierer, K. (2016): Atraumatic needles for lumbar puncture: why haven't neurologists changed? In Practical neurology 16 (1), pp. 1822. DOI:10.1136/practneurol-2014-001055.0
2 Engedal, ThorbjørnS.; Ørding,Helle;Vilholm, Ole Jakob (2015): Changing the needle for lumbar punctures: results from a prospective study. In Clinical neurology and neurosurgery 130, pp. 7479. DOI:10.1016/j.clineuro.2014.12.020.
3 Tung, C. E.; Yuen, T. S.; Lansberg,M. G. (2012): Cost comparison between the atraumatic and cutting lumbar puncture needles. In Neurology 78, pp. 109113.
4 Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas,Natalia; Ciapponi, Agustín; Arevalo, Jimmy J.; Boogaard, Sabine; RoquéI Figuls, Marta (2017): Needle gauge and tip designs for preventing post-dural puncture headache (PDPH). In The Cochrane database of systematic reviews 4,CD010807. DOI: 10.1002/14651858.CD010807.pub2.
5 McLaughlin, Colleen A.; Hockenberry, Marilyn J.; Kurtzberg, Joanne; Hueckel, Rémi; Martin, Paul L.; Docherty, Sharron L. (2014): Standardization of health careprovider competencies for intrathecal access procedures. In Journal ofpediatric oncology nursing: official journal of the Association of PediatricOncology Nurses 31 (6), pp. 304316. DOI: 10.1177/1043454214543019.
6 Nath, Siddharth; Koziarz, Alex; Badhiwala, JetanH.; Alhazzani,Waleed; Jaeschke, Roman; Sharma, Sunjayet al. (2018): Atraumatic versus conventional lumbar puncture needles: asystematic review and meta-analysis. In The Lancet 391 (10126), pp. 11971204.DOI: 10.1016/S0140-6736(17)32451-0.
7 Rochwerg, Bram; Almenawer, Saleh A.; Siemieniuk, Reed A. C.; Vandvik, Per Olav; Agoritsas, Thomas; Lytvyn, Lyubovet al. (2018): Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline. In BMJ, k1920. DOI:10.1136/bmj.k1920.
8 Zhang, Yi C.; Chandler, Alexander J.; Kagetsu, Nolan J. (2014): Technical compliance to standard guidelines for lumbar puncture and myelography: survey of academic neuroradiology attendings and fellows. In Academic radiology 21 (5), pp. 612616. DOI:10.1016/j.acra.2014.01.021.
9 Bellamkonda, Venkatesh R.; Wright, Thomas C.; Lohse, Christine M.; Keaveny,Virginia R.; Funk, Eric C.; Olson, Michael D.; Laack,Torrey A. (2017): Effect of spinal needle characteristics on measurement ofspinal canal opening pressure. In The American journal of emergency medicine 35(5), pp. 769772. DOI: 10.1016/j.ajem.2017.01.047.
10 Puolakka, R.; Andersson, L. C.; Rosenberg, H. (2000): Microscopic Analysis of Three Different Spinal Needle Tips After Experimental Subarachnoid Puncture. In Regional Anesthesia and Pain Medicine 25 (2), pp. 163169.
11 Lavi R., Rowe J.M., Avivi I.Lumbar Puncture. It Is Time to Change the Needle, EurNeurol, 2010; 64:108113
