Therapy
|
Effectiveness
(as judged from my personal experience,
your
mileage may vary a whole lot!) |
Advantages
|
Disadvantages
|
|
Local anesthetic injections
(e.g. Lidocaine)
|
Very effective; pain
control wears off slowly helping control post-procedure anxiety. |
Readily available, most
commonly used therapy; economical. |
Painful! Also acts to
intensify
needle phobia and therefore not recommended.
Giving injections to a needle phobe is oxymoronic anyway.
Not recommended.
|
|
Ethyl Chloride spray
(and ice and other freezing techniques)
|
Very poor |
Easily administered, not
painful but a bit unpleasant. |
Effectiveness is very poor,
provides only extremely superficial pain control.
Not recommended.
|
|
Topical Anesthetic
Creams
EMLA Cream
Click on EMLA tube above for larger image showing the new child-proof
cap assembly
Click on the image above for link to the EMLA web site maintained by
the manufacturer, AstraZeneca Pharmaceuticals LP.
EMLA Disc
Ametop Gel
Click to visit manufacturer's web site
Note: Ametop is not available in the United States
TAC
(topical containing cocaine)
|
EMLA: Fair to Poor |
Totally painless; portable
(can be carried by patient) |
Not effective for most injections unless
very superficial;
messy, expensive, EMLA takes so long (1-2 hours) that preplanning
is very important.
The manufacturer of Ametop claims their gel works in less than hour and
lasts up to 6 hours.
Not useful for emergencies or for wound
closure.
TAC contains cocaine is therefore almost
impossible to legally obtain and it is impressively expensive.
|
|
Jet Injectors
|
May be helpful in some
persons in limited situations. |
Completely eliminates any
anxiety over seeing a needle because there is no needle, just a burst
of high-pressure gas. Probably easier to use than needles for patients
who self-inject; completely eliminates concerns over needle-stick
injuries between persons. |
Needleless and painless are
not
the same thing. Some people report injectors are less painful than
needles
while others report they are more painful; it is rare to find a doctor
or clinic with one of these devices - you pretty much have to buy it
(~$500).
Worse, injectors only work in very limited
situations such as insulin and some inoculations. Since they cannot be
used for blood draws, IV fluids, IV injections and deep IM injections,
they are an incomplete solution at best.
|
|
Anxiolytic medications
(Valium, Nitrous Oxide, Xanax, etc)
|
Varies widely from very
effective to completely ineffective depending upon the root cause of
the phobia and individual response variability. |
Portable (except for
nitrous),
can be administered by patient at home prior to procedure, relatively
inexpensive, fairly safe. |
If your problem is only
anxiety
and these medications are effective then it may be the best choice. If
pain is the central issue, then anxiolytics will be inadequate since
they
don't provide analgesia. |
|
Iontophorectic
topical
anesthesia
Click
here
to visit Iomed
Click here to
visit
Life-Tech
|
Very effective: works by
driving an anesthetic drug like Lidocaine through the skin by using a
small electric current. Numbs the skin for about a hour, plenty of time
to have needle procedure (injection, blood draw, IV) completed.
|
Provides excellent anesthesia
to depths sufficient for most punctures; portable (about the size of a
pack of cigarettes and uses a cheap 9V battery); inexpensive enough
that a
highly-motivated patient could purchase one for their own use (~$450)
although
its purchase cost is not usually covered by insurance. |
Poor availability - very
unusual to find a doctor or test center with this equipment; a bit
expensive to buy; consumables are expensive making each application
cost about $8; takes 15-20 minutes and the setup is quite inconvenient;
not safe for use in wounds.
Limited effectiveness for deep punctures like IM injections. |
Behavioral therapies
(hypnotherapy, relaxation, psychotherapy, distraction, etc).
|
Fair to very poor,
depending upon the person, the cause and intensity of their condition,
skill, determination, etc. |
Puts patient in control; can
be used anytime and for any procedure; costs nothing after skills
acquired. If it works for you, probably the best option. |
For most phobes, probably very
inadequate; somewhat expensive and time-consuming to acquire skills
especially if professional help is used. |
|
Inhalation General Anesthesia
|
Extremely effective. |
Potent enough to overcome any
anxiety or pain; painless; lack of memory of procedure can aid in
reducing future anxiety and pain. If your fear is severe enough and
other techniques prove inadequate, this is your ultimate solution. |
Difficult to convince
clinicians (and insurance companies) to use this technique; may be
risky; very high cost; may require hospital stay; may cause extreme
nausea.
Generally impractical for simple procedures
like inoculations.
|
