We use it in our ED. I tend to use it mainly for LP's. I still have to use
injectable Lidocaine to anesthetize the deeper tissues( ligaments and dura).
With Numby, the entire LA can become painless. I prefer it to EMLA for 2
reasons. One is, the time to onset, which is only 10 minutes, as opposed to
45 minutes to an hour with EMLA. Secondly, the depth of LA is greater with
Numby (upto 10 mm as opposed to 5-6 mm with EMLA).
The nurses in our ED our divided on it use for IV starts. Some of the more
experienced ones seem to prefer to just go ahead and start the IV in one
stick. They find that 10 minutes of Numby with its attendant "burning" at
the site is not worth it. Moreover, they feel that the Epi in Numby causes
vasoconstriction and impedes proper vein visualization.
I have not reviewed the data to comment on its success or efficacy. For a
very anxious "needle-phobic" patient it may have a role.
Jay Pershad, M.D.
Lebonheur Childrens's Medical Center
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