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Patient Pain and Tissue Trauma During Syringe Procedures: A Randomized Controlled Trial GAUTAM R. MOORJANI, ADRIAN A. MICHAEL, ANDRES PEISAJOVICH, KYE S. PARK, WILMER L. SIBBITT Jr, and ARTHUR D. BANKHURST
ABSTRACT. Methods. Forty-seven subjects with a palpable knee effusion underwent needle and syringe aspiration. Subjects were randomized to the conventional syringe or a safety technology, the reciprocating procedure device (RPD). This trial was registered at clinicaltrials.gov. Pain was measured with the Visual Analog Pain Scale (VAPS). Cell count, crystal examination, culture, and aspirated fluid volume were determined. Red blood cell (RBC) counts were used to measure blood in aspirated fluid. Results. Patient pain during the syringe procedure significantly predicted blood (RBC) in aspirated fluid (r = 0. 53, p = 0.001). When compared to the conventional syringe, the RPD safety device reduced blood in aspirated fluid by 66.7% (RBC, 103/ml: RPD 8.9 ± 11.4; syringe 26.7 ± 90.2; p 0.01), reduced patient pain by 73.9% (VAPS: RPD 1.68 ± 2.34; syringe 6.44 ± 2.86; p < 0.01), and improved fluid aspirate yield by 132% (aspirate volume: RPD 20.9 ± 19.7 ml; syringe 9.00 ± 6.58 ml; p < 0.01). Conclusion. Inadequate control of needle and syringe during physician-performed syringe procedures is an important cause of trauma to patient tissues resulting in hemorrhage, increased patient pain, and decreased aspirate yield. The RPD -- a safety device that improves needle control and decreases needle trauma to tissues -- reduces hemorrhage and improves the safety, outcome, and aspirate yield of physician-performed syringe procedures. (J Rheumatol First Release April 15 2008) Key Indexing Terms:
SYRINGE
From the Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA. G.R. Moorjani, MD, Fellow; A.A. Michael, MD, Fellow; A. Peisajovich, MD, Fellow; K.S. Park, MD, Fellow, Rheumatology; W.L. Sibbitt Jr, MD, Professor of Internal Medicine, Rheumatology, and Neurology; A.D. Bankhurst, MD, Professor of Internal Medicine and Rheumatology, University of New Mexico Health Sciences Center. Address reprint requests to Dr. W.L. Sibbitt Jr, Department of Internal Medicine, Division of Rheumatology, MSC10 - 5550 5th Fl, ACC, University of New Mexico Health Sciences Center, Albuquerque, NM 87131. E-mail: wsibbitt@salud.unm.edu Accepted for publication January 10, 2008. |
