Iontophoresis
Iontophoresis is a technique for delivering dermal analgesia quickly (in 10 to 20 minutes) with minimal discomfort and without distorting the tissue. The Numby 900 iontophoretic drug-delivery system is a handheld device with two electrodes that uses a mild electric current to deliver charged ions of lidocaine 2% and epinephrine 1:100,000 solution into the skin. The device is powered by a 9-volt battery.
Local anesthetic agents, such as those administered through iontophoresis, should be considered before IV insertion.1 Because iontophoresis acts quickly, it’s an excellent choice for numbing an IV insertion site, especially in children.
Equipment
Dose-control device with battery ▪ drug-delivery electrode kit ▪ lidocaine 2% with epinephrine 1:100,000 solution ▪ alcohol pads ▪ syringe with needle ▪ gloves ▪ tongue blade.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.5
Ask the patient or, if the patient is a child, ask the parents if he has any allergies or sensitivity to medications. Avoid using iontophoresis in patients with implanted devices such as a pacemaker.
Explain the procedure to the patient and tell him that he may feel tingling or warmth under the electrode pads while they’re on the skin.
Assess the patient for appropriate electrode placement. You’ll place a medication-delivery electrode over the intended IV insertion site. The second electrode, which drives drug ions into the skin, must be applied over a muscle 4″ to 6″ (10 to 15 cm) away.
Put on gloves. Examine the patient’s skin and select intact electrode placement sites, avoiding areas with pimples, unhealed wounds, or ingrown hairs. With alcohol pads, briskly rub an area slightly larger than the electrode at each site.
Remove the paper flap from the back of the drug-delivery electrode.
Draw up the lidocaine with epinephrine in a syringe. Remove the needle from the syringe and saturate the medication pad with the amount of lidocaine and epinephrine solution indicated on the electrode pad (as shown below). The amount of lidocaine and epinephrine solution required to saturate the pad varies with pad size: for a standard-sized pad, use about 1 mL; for a large pad, use about 2.5 mL.
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