Intravenous Route

Intravenous Route

Historical Background

  • Early Experiments:

    • Developed in 1656 by Sir Christopher Wren, who created a primitive syringe.

    • Conducted experiments by injecting wine, ale, and opium into dogs.

  • First Human IV Medication:

    • Administered by Johann Daniel Major in 1662.

    • Temporary abandonment due to complications (thrombosis, embolism).

  • Revival:

    • 19th-century due to the invention of the hypodermic syringe.

    • Common use of sodium chloride and glucose IV solutions by the 20th century.

Current Practices

  • Routine procedure in hospitals, but carries recognized risks.

  • Risks include thrombus and embolus formation, and particulate matter in solutions.

Advantages of IV Drug Administration

  • Rapid action due to bypassing drug absorption.

  • Lifesaving in emergencies as drugs act quickly.

Disadvantages of IV Drug Administration

  • Drugs cannot be easily retrieved post-injection, presenting risks during adverse reactions.

  • Significant dosing variations between oral and IV routes.

Venipuncture Details

  • Suitable veins: basilic and cephalic veins (back of hand, dorsal forearm).

  • Avoid antecubital vein due to high risk of extravasation.

Aseptic Technique

  • Use sterilized syringes and needles.

  • Skin entry points must be rigorously disinfected.

Infusion Practices

  • Small and large volume drug solutions delivered, often using 1,000-mL containers.

  • Infusion rates range from 42 to 150 mL/h depending on patient needs.

Hazards of IV Infusion

  • Main hazard: thrombus formation, which can lead to embolisms.

  • Solutions must be aqueous to avoid complications like pulmonary occlusion.

IV Fat Emulsions

  • Used in prolonged parenteral nutrition; includes Intralipid and Liposyn.

  • Administered through peripheral veins or central venous infusion.

Patient-Controlled Analgesia (PCA)

  • Introduced in the late 1980s for self-administration of analgesics.

  • Enables quick delivery of pain relief alongside stable concentrations for ongoing management.

  • Reduces variability in opioid kinetics, enhancing patient control and experience.

  • Devices can be programmed for IV, SC, or epidural administration, including specific dosage protocols.