Use of finer needles for venipuncture increases in vitro haemolysis despite reducing persistent pain and nerve injury: A retrospective study.

IF 2.1 4区 医学 Q3 MEDICAL LABORATORY TECHNOLOGY
Annals of Clinical Biochemistry Pub Date : 2024-03-01 Epub Date: 2023-08-29 DOI:10.1177/00045632231196045
Hiroshi Umemura, Hiromichi Takahashi, Yoshiaki Fukuda, Hitoshi Soma, Rumiko Aoki, Norihisa Takei, Tomohiro Nakayama
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引用次数: 0

Abstract

Background: Although venipuncture is minimally invasive, and is the most frequently performed medical procedure, it carries the small risk of causing persistent pain, including nerve damage. Recently, our hospital stopped using 22-gauge needles for venipuncture in outpatients and switched to using only 23- and 25-gauge needles. We investigated the impact of using only the finer needles on the incidence of persistent or neuropathic pain and the prevalence of haemolysis, as well as the impact of haemolysis associated with the needle change on other laboratory data.

Methods: We retrospectively collected and analysed data on venipuncture-associated pain complaints made during the 1-year period prior and 1-year period after the change in needles, as well as the frequency of haemolysis before and after the change. We also focused on 90 cases that showed significant haemolysis after the needle change and compared the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels before and after the needle change.

Results: The incidence of persistent pain was significantly reduced from 1 in 10,825 venipunctures before the change to 1 in 29,747 venipunctures after the change. Notably, no patients experienced neuropathic pain after the change. However, the prevalence of haemolysis was significantly increased. Additionally, the serum aspartate aminotransferase, lactate dehydrogenase, and potassium levels were significantly elevated in the cases that showed moderate to gross haemolysis after the needle change.

Conclusion: Using finer needles involves both advantages and disadvantages, and careful consideration is needed to determine which type of needle is in the best interests of the patient.

使用更细的针头进行静脉穿刺会增加体外溶血,尽管会减少持续疼痛和神经损伤:一项回顾性研究。
背景:虽然静脉穿刺是一种微创手术,而且是最常进行的医疗程序,但它也存在引起持续疼痛(包括神经损伤)的微小风险。最近,我们医院停止使用 22 号针头为门诊病人进行静脉穿刺,转而只使用 23 号和 25 号针头。我们研究了只使用更细的针头对持续性疼痛或神经性疼痛发生率和溶血发生率的影响,以及与换针相关的溶血对其他实验室数据的影响:我们回顾性地收集并分析了更换针头前 1 年和更换针头后 1 年期间静脉穿刺相关疼痛投诉的数据,以及更换针头前后溶血的频率。我们还重点研究了换针后出现明显溶血的 90 个病例,并比较了换针前后的血清天冬氨酸氨基转移酶、乳酸脱氢酶和血钾水平:结果:持续疼痛的发生率明显降低,从更换针头前的每 10,825 次静脉穿刺中有 1 次发生持续疼痛,降至更换针头后的每 29,747 次静脉穿刺中有 1 次发生持续疼痛。值得注意的是,更换针头后没有患者出现神经性疼痛。不过,溶血的发生率明显增加。此外,在更换针头后出现中度至严重溶血的病例中,血清天冬氨酸氨基转移酶、乳酸脱氢酶和血钾水平明显升高:结论:使用更细的针头有利也有弊,需要慎重考虑,以确定哪种针头对患者最有利。
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来源期刊
Annals of Clinical Biochemistry
Annals of Clinical Biochemistry Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
5.20
自引率
4.50%
发文量
61
期刊介绍: Annals of Clinical Biochemistry is the fully peer reviewed international journal of the Association for Clinical Biochemistry and Laboratory Medicine. Annals of Clinical Biochemistry accepts papers that contribute to knowledge in all fields of laboratory medicine, especially those pertaining to the understanding, diagnosis and treatment of human disease. It publishes papers on clinical biochemistry, clinical audit, metabolic medicine, immunology, genetics, biotechnology, haematology, microbiology, computing and management where they have both biochemical and clinical relevance. Papers describing evaluation or implementation of commercial reagent kits or the performance of new analysers require substantial original information. Unless of exceptional interest and novelty, studies dealing with the redox status in various diseases are not generally considered within the journal''s scope. Studies documenting the association of single nucleotide polymorphisms (SNPs) with particular phenotypes will not normally be considered, given the greater strength of genome wide association studies (GWAS). Research undertaken in non-human animals will not be considered for publication in the Annals. Annals of Clinical Biochemistry is also the official journal of NVKC (de Nederlandse Vereniging voor Klinische Chemie) and JSCC (Japan Society of Clinical Chemistry).
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