SUBCUTANEOUS ADMINISTRATION OF MIDAZOLAM - A COMPARISON OF THE BIOJECT JET INJECTOR WITH THE CONVENTIONAL SYRINGE AND NEEDLE

Purpose: The purpose of this study was to compare jet injection to a s yringe and needle in terms of the difference in discomfort and pharmac okinetics after the subcutaneous administration of midazolam. Patients and Methods: Using a prospective, randomized, double-blinded study de sign, 14 subjects were administered midazolam on two separate occasion s (at least 2 weeks apart). The subjects were randomly distributed int o two groups: syringe and needle (saline)/jet injector (midazolam) or syringe and needle (midazolam)/jet injector (saline). The subjects wer e randomly assigned to receive either EMLA. (eutectic mixture of local anesthesics) or a placebo at the injection site for the first adminis tration and the other topical agent on the second visit. Each subject received one subcutaneous injection in the deltoid region per arm per day. Each injection contained the same volume of solution. Subjects co mpleted visual analog scale (VAS) questionnaires assessing the discomf ort of the injection. Blood samples were taken at specified intervals over 2 hours for determination of midazolam levels. Results: The disco mfort associated with the injection was less with the Biojector 2000 ( Bioject Inc, Portland, OR) although this was not statistically signifi cant. However, persistent discomfort was significantly greater at the needle site. The mean peak plasma level of midazolam was achieved more rapidly with the Biojector 2000 than with the syringe and needle (P < .05). However, the peak plasma level after jet injection or injection with a syringe and needle was not statistically different. Conclusion : The results of the study show that the Biojector 2000 is a needle-fr ee injection system that can be used for the administration of a preme dicant before induction of anesthesia. It has several advantages, incl uding the potential reduction of anxiety associated with the ''fear of needles'' and occupational injuries.