No Stick, Double Click, Pain Relief

Newswise — For those who want to avoid the needle stick or being attached to a pain pump required for medication, a new device that adheres to the skin's surface may provide full pain relief at the double click of a button.

The new self-contained device, currently under Food and Drug Administration (FDA) investigation, delivers pain medication through the skin using a low-level electric current—all at the patient's control.

This could mean an end to general discomfort from needles or intravenous (I.V.) catheters and an increase in patient safety by reducing drug mix-ups and other potential problems, reported Eugene R. Viscusi, M.D., Director, Acute Pain Management Service, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, at the 2003 American Society of Anesthesiologists Annual Meeting.

"This technology could also eliminate the need for cumbersome pain pumps mounted to an I.V. pole with the accompanying tubes and wires and could provide more continuous, complete pain relief," Dr. Viscusi said.

The new device, known as a patient-controlled transdermal system (PCTS), is roughly the size of a credit card but slightly thicker and is worn on the upper arm or chest. The PCTS dispenses medication during a 10-minute time period when activated by the patient. The device shuts off automatically at 24 hours. Although the PCTS is new, the technology of using a low-level electric current to deliver medication is not. According to Dr. Viscusi, iontophoretic delivery, or charged medicine ions being driven across the skin, has existed for years with larger units.

"This is a marvel of miniaturization; the older devices were huge," he said. "This device is small and smart with a system that provides the correct amount of pain medication needed for each particular patient."

Unlike other "patches" that slowly and continually deliver drugs, the PCTS only delivers pain relief when the patient double clicks a button to activate the device. Otherwise, the drug resides safely inside the device and cannot penetrate the skin, Dr. Viscusi said.

The study enrolled 474 patients and used the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Pain Management Standards as a guide to patient education and treatment of pain. The study showed the new PCTS device to be statistically superior to the "dummy" PCTS in several areas. Also, most patients were very satisfied with the PCTS for treatment of postoperative pain, finding it easy to use and convenient.

Of the many conveniences of the PCTS, researchers noted that patients might be able to rehabilitate faster because of greater mobility. Because the PCTS is small, neat and completely in the patient's control, researchers also found it to have many significant improvements over the current patient-controlled pumps used to treat pain.

"With this device, patients don't have all the paraphernalia connecting them to technology, avoiding a real burden that inhibits movement, daily activities and physical therapy," Dr. Viscusi said.

Dr. Viscusi said he believes that patients will not be the only ones to embrace the new device. He said that nurses will have more time to be patient-centered due to the reduced time spent addressing equipment issues.

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