Patient Pain and Tissue Trauma During Syringe Procedures: A Randomized Controlled Trial

• Published in: Journal of rheumatology 2008-06, Vol.35 (6), p.1124-1129
• Main Authors: MOORJANI, Gautam R, MICHAEL, Adrian A, PEISAJOVICH, Andres, PARK, Kye S, SIBBITT, Wilmer L, BANKHURST, Arthur D
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Diseases of the osteoarticular system; Equipment Design; Female; Humans; Injuries of the limb. Injuries of the spine; Knee; Knee Injuries - etiology; Male; Medical sciences; Middle Aged; Pain; Pain Measurement; Suction - adverse effects; Suction - instrumentation; Synovial Fluid; Syringes - adverse effects; Traumas. Diseases due to physical agents
• ISSN: 0315-162X; 1499-2752

Objective To investigate the relationship of needle control to tissue trauma and hemorrhage during syringe procedures. 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, 10 3 /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. Key Indexing Terms: SYRINGE PROCEDURE ARTHROCENTESIS SYNOVIAL INJECTION RECIPROCATING DEVICE