|
|
||||||||
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
Med Hypotheses. 2007 Jan 18; [Epub ahead of print] .L.A. Pain Clinic, Hawthorne,
California Med Hypotheses. 2005;65(3):559-69 Pain
Med. 2005 Mar-Apr;6(2):149-51
|
J
Pain.
2006 Aug;7(8):608-9 ·
Omoigui S, ·
Adewumi PA, ·
Do Y, ·
Elenes G. .Division
of Inflammation and Pain Research, L.A. Pain Clinic, Hawthorne, California. PMID: 16885018 [PubMed - in process] At the LA Pain Clinic,
IM and SQ injections are administered on a daily basis either as part of our
therapeutic procedures or during pre-medication in patients that are
scheduled to have procedures. Recently it was
observed that patients were consistently complaining of more pain during the
SQ injections, even though the SQ needle was a 25G short 5/8" and the IM
needle was a 25G long11/2". We noted that the needles were from
different manufacturers. The 25G IM Precisionglide needles were manufactured
by Becton Dickinson (BD) and the 25G SQ needles were manufactured by Terumo.
We then ordered 25G 5/8 SQ Precisionglideä needles of same
gauge and length in order to compare both the Terumo and the BD needles. We then compared
the intensity of pain perceived by our patients by the two types of needles.
Our objective was to determine if needles with a different bevel design but
the same size, diameter and length would result in a different pain
experience. We did not see any prior
publication of such a study. At the beginning
of this study the assessment of patients level of pain was based on a
ten-point unit numeric scale. With the pain level of 0/10 interpreted
as the least amount of pain while the pain level of 10/10 is interpreted as
the worst amount of pain. Twenty patients
were studied in all. These patients were selected sequentially. Which means
that every patient that required a procedure was studied. With informed
consent, each patient was injected with local anesthetic (Lidocaine 0.5%)
using the 25 G 5/8 Terumo needle and a 25 G 5/8 BD as part of our
pre-procedure local anesthetic infiltrations. For each patient studied, the Terumo
needles and BD needles were used alternately to inject anesthetics on
different sites of procedure. Care was taken to ensure that the same person
for all the patients studied carried out the injections. Care was also taken
to start the injections with different needle types on each patient. Patients were
asked at the time of each injection the level of pain they felt at the time
the skin is pierced. After injecting
nineteen different patients we observed that in all patients the subjective
pain level described was significantly higher for the Terumo needle
injections. Analysis of the data
showed that the mean pain score for the BD needle was 2 while the mean pain
score for the Terumo needle was 5.6. The least pain and highest pain score experienced for the two sets of
needles was different. With the BD needle the least pain score was 0 while
with the Terumo needle the least pain score was 3. With the BD needle the highest pain score was 6 while with the
Terumo needle the highest pain score was 8. It was evident
that the pain experience was much better for our patients when the local
anesthetic injection was performed with the BD needle. We therefore conclude
that the Terumo needle inflicts more pain to our patients. The Terumo needles
incorporate a double bevel design to provide ultra sharp needles, while the
BD Precisionglideä needles
incorporate an advanced low-angle bevel design, a unique polishing process
and a low friction lubricant to improve penetration ease (See Fig 1 and
2).
Figure
1 – BD Needle[i]
Figure
2 – Terumo Needle[ii]
In conclusion, the pain experience with needles of
the same size is determined by the bevel design and not by the length. Sincerely, Sota Omoigui, MD Peter A. Adewumi
MD Yvone Do MD German Elenes MD Division of Inflammation
and Pain Research L.A. Pain Clinic 4019 W. Rosecrans
Ave Hawthorne, CA
90250 |
