Dr Douglas Stein
Florida, USA
Dr Charles Monteith
North Carolina, USA
Dr Nei Pollock
B.C, Canada
Dr Raj Selvarajan
Queensland, AUS
Taking the Sting out of Anesthesia
Local anesthesia with the MadaJet injector reduces patient discomfort and anxiety. This pen sized device injects anesthetic solution as deep as a needle can go virtually pain free. It uses pneumatic pressure to create a high-pressure spray through a tiny orifice, creating a fine stream that acts as a "liquid needle". The solution is dispersed in a cone-shaped distribution, penetrating up to 6mm deep and perfusing all tissues in its path, providing a more profound and rapid anesthetic effect compared to traditional needle delivery.
Introduction to the MadaJet
Components of the MadaJet
Preparation and Maintenance
No-Needle Technique
Introduction to the MadaJet
What is the MadaJet Injector?
Madajet is a durable device that can stand up to rigorous use and requires very little maintenance. If well maintained, an injector can last for up to 10 years.
It’s good to familiarize yourself with the various parts of the injector. Review the instructional materials provided in the package with the injector. They not only help you to get the best use of the injector but also include certain cautionary warnings to help you avoid unsafe practices.
Components of the MadaJet
MadaJet Injector: Parts and Functions
Body
The main housing of the MadaJet injector, providing structural support and encasing the internal mechanisms. It’s ergonomically designed for comfortable handling during medical procedures, ensuring stability and precision in anesthetic delivery.
Head Assembly
A crucial component containing the precise mechanism for anesthetic delivery. It houses the spring-loaded piston that generates the high-pressure jet, enabling needle-free injection. The head assembly ensures consistent and controlled medication dispersal.
Pyrex Glass Fill Chamber
A transparent, durable container capable of holding up to 4 cc’s of anesthetic solution. Its glass construction allows for visual confirmation of liquid levels and absence of air bubbles, crucial for accurate dosing and safe injections.
Cocking Lever
A mechanical arm used to compress the internal spring mechanism, preparing the device for injection. It requires minimal force to operate, allowing for quick and easy preparation between injections, enhancing efficiency in clinical settings.
Release Button
The trigger mechanism that, when pressed, releases the compressed spring, initiating the high-pressure injection. Its sensitivity and positioning are optimized for precise control, allowing healthcare providers to deliver injections with minimal hand movement.
Shaft
The elongated section connecting the body to the injection site. It provides the necessary length for reaching specific anatomical areas, particularly useful in urological procedures. The shaft’s design balances reach with maneuverability.
Finger Rests
An ergonomic feature designed to provide stability during injection. It allows the healthcare provider to maintain a steady grip and precise control over the device, enhancing accuracy and reducing the risk of movement during anesthetic delivery.
Extenda Tip
A specialized component at the end of the shaft that allows for precise positioning of the injection site. Its design facilitates accurate placement against the skin or mucosa, ensuring optimal anesthetic dispersal into the target tissue.
Stainless Steel Sheath
A removable, sterilizable cover for the extended tip. It maintains sterility between patients and can be easily changed or autoclaved. The sheath’s durable stainless steel construction withstands repeated sterilization cycles without degradation.
Jet Injector Holder
A dedicated stand designed to securely hold the MadaJet when not in use. It provides a stable resting place for the device, preventing contamination and accidental discharge while also keeping the injector readily accessible during procedures.
Stylets
Thin, rigid cleaning tools designed for maintaining the injector’s small orifices and channels. These precision instruments are crucial for removing any potential blockages or residue, ensuring consistent performance and longevity of the device.
Preparation and Maintenance
MadaJet XL: Preparation and Maintenance Guide
Preparation for Use
- Fill the Pyrex glass chamber with anesthetic (minimum 2% concentration):
- Use a dental syringe or a multiple-dose 30cc sterile vial
- Ensure the chamber is filled to at least the 2cc mark
- Prime the head assembly:
- Hold the device vertically with the tip pointing upward
- Cock and fire the device several times until anesthetic is visible at the tip
- Perform a test fire:
- Aim at a paper towel or other absorbent material
- Cock the device using the cocking lever
- Press the release button to fire
Pro Tip: Always perform a test fire before each use to ensure proper function and familiarize yourself with the device’s sound and feel.
Daily Maintenance
- Flush the injector:
- Use distilled or demineralized water
- Fill the chamber and fire several times
- Perform ultrasonic cleaning:
- Partially immerse the main body (avoid liquid entering the spring chamber)
- Use an enzymatic cleaner solution
- Clean for 10-15 minutes
- Autoclave the device:
- Follow manufacturer’s instructions for autoclave settings
- Typically 121°C (250°F) for 30 minutes
Between-Patient Sterilization
- Disinfect the device:
- Use Madacide-FD or another approved hospital-level disinfectant
- Follow manufacturer’s instructions for cold sterilization/disinfection times
- Sterilize the stainless steel sheath:
- Remove the sheath from the device
- Autoclave according to manufacturer’s instructions
- Replace the sheath with a sterile one before next use
Important: Always maintain the same pairing of heads and bodies if multiple injectors are owned to ensure optimal performance.
Long-term Maintenance
- Regular inspection:
- Check for signs of wear, especially on rubber O-rings
- Monitor injection sound – a change from a quiet “phhht” to a louder pop may indicate maintenance is needed
- Professional servicing:
- Send the device to the manufacturer when wear is detected
- Typically needed for seal replacement and other internal maintenance
No-Needle Technique
A Step-by-Step Guide for No-Needle Vasectomy
Video by Dr Ronald S Weiss
Steps for No-Needle Vasectomy
1. Position the patient in a comfortable supine position and properly drape the surgical area.
2. Use the three-finger technique to isolate and immobilize the vas deferens under the midline of the scrotal skin:
- Place your thumb on the anterior surface of the scrotum.
- Place your middle finger behind the scrotum.
- Place your index finger next to your middle finger, also behind the scrotum.
- Use these three fingers to gently elevate and isolate the vas deferens under the scrotal skin.
3. Engage the cocking lever by pulling it back fully until you hear it click. This is to prime the injector to be fired.
4. With the vas deferens held firmly in place by your fingers, place the metal Weiss sheath of the MadaJet directly against the scrotal skin over the vas.
- Ensure the sheath is positioned perpendicular to the skin for optimal penetration.
4. Push the release button to deliver the first “puff” of anesthetic solution through the scrotal skin and around the vas deferens.
- The jet will create a single, pinpoint puncture site in the skin.
- Patients describe a sensation similar to a rubber band snap against the skin.
5. Immediately after the first puff, recock the lever by pulling it back fully to prime for the next injection.
Reposition the sheath slightly (1-2 cm) along the path of the vas and administer a second puff of anesthetic. Recock and reposition again if you choose to deliver a third puff of anesthetic along the same vas deferens.
6. Allow 10-20 seconds for the anesthetic to take full effect and produce blanching of the skin, indicating sufficient anesthetic dispersion.
7. Repeat steps 2-8 on the opposite side to thoroughly anesthetize the other vas deferens.
Hands on Vasectomy Training
Hands-on training is crucial when learning to perform the No-Needle technique. While written presentations and video demonstrations are valuable, they cannot fully replicate the nuanced tactile feedback and real-time decision-making required during the procedure. Direct supervision by an experienced practitioner allows trainees to refine their technique, learn proper patient positioning, and master the precise handling of the MadaJet injector to achieve optimal anesthetic distribution without needle penetration.
Card #1
Lorem ipsum dolor sit amet, mea ei viderer probatus consequuntur, sonet vocibus lobortis has ad. Eos erant indoctum an, dictas invidunt est ex, et sea consulatu torquatos. Nostro aperiam petentium eu nam, mel debet urbanitas ad, idque complectitur eu quo. An sea autem dolore dolores.
Card #2
Lorem ipsum dolor sit amet, mea ei viderer probatus consequuntur, sonet vocibus lobortis has ad. Eos erant indoctum an, dictas invidunt est ex, et sea consulatu torquatos. Nostro aperiam petentium eu nam, mel debet urbanitas ad, idque complectitur eu quo. An sea autem dolore dolores.
Card #3
Lorem ipsum dolor sit amet, mea ei viderer probatus consequuntur, sonet vocibus lobortis has ad. Eos erant indoctum an, dictas invidunt est ex, et sea consulatu torquatos. Nostro aperiam petentium eu nam, mel debet urbanitas ad, idque complectitur eu quo. An sea autem dolore dolores.
Card #4
Lorem ipsum dolor sit amet, mea ei viderer probatus consequuntur, sonet vocibus lobortis has ad. Eos erant indoctum an, dictas invidunt est ex, et sea consulatu torquatos. Nostro aperiam petentium eu nam, mel debet urbanitas ad, idque complectitur eu quo. An sea autem dolore dolores.
