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WILMER L. SIBBITT Jr, RANDY R. SIBBITT, ADRIAN A. MICHAEL, DRUCE I. FU, HILDA T. DRAEGER, JON M. TWINING, and ARTHUR D. BANKHURST ABSTRACT. Methods. Twenty-six physicians were tested for their individual ability to control the reciprocating and conventional syringes in typical aspiration-injection procedures using a novel quantitative needle-based displacement procedure model. Subsequently, the physicians performed 48 clinical aspiration-injection (arthrocentesis) procedures on 32 subjects randomized to the reciprocating or conventional syringes. Clinical outcomes included procedure time, patient pain, and operator satisfaction. Multivariate modeling methods were used to determine the experimental variables in the syringe control model most predictive of clinical outcome measures. Results. In the model system, the reciprocating syringe significantly improved physician control of the syringe and needle, with a 66% reduction in unintended forward penetration (p < 0.001) and a 68% reduction in unintended retraction (p < 0.001). In clinical arthrocentesis, improvements were also noted: 30% reduction in procedure time (p < 0.03), 57% reduction in patient pain (p < 0.001), and a 79% increase in physician satisfaction (p < 0.001). The variables in the experimental system — unintended forward penetration, unintended retraction, and operator satisfaction — independently predicted the outcomes of procedure time, patient pain, and physician satisfaction in the clinical study (p ≤ 0.001). Conclusion. The reciprocating syringe reduces procedure time and patient pain and improves operator satisfaction with the procedure syringe. The reciprocating syringe improves physician performance in both the validated quantitative needle-based displacement model and in real aspiration-injection syringe procedures, including arthrocentesis. (First Release Mar 1, 2006; J Rheumatol 2006;33:771-8)
Key Indexing Terms: SYRINGE
From the Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico; Department of Emergency Medicine, Maricopa Medical Center, Phoenix, Arizona; and Department of Radiology, St. Peter's Hospital, Helena, Montana, USA. AVANCA Medical Devices, Inc., Albuquerque, NM, donated the syringes for this study. W.L. Sibbitt Jr, MD, Professor of Internal Medicine and Neurology, University of New Mexico Health Sciences Center; R.R. Sibbitt, MD, Director, Interventional Radiology, St. Peter's Hospital; A.A. Michael, MD, Resident, Internal Medicine, University of New Mexico Health Sciences Center; D.I. Fu, MD, Resident, Department of Emergency Medicine, Maricopa Medical Center; H.T. Draeger, MD, Fellow; J.M. Twining, MD, Fellow; A.D. Bankhurst, MD, Professor of Internal Medicine, University of New Mexico Health Sciences Center. Address reprint requests to Dr. W.L. Sibbitt Jr, Department of Internal Medicine, 5th Floor ACC, Division of Rheumatology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131. E-mail: wsibbitt@salud.unm.edu Accepted for publication November 25, 2005.
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