Comparison of two needle sizes for subcutaneous administration of enoxaparin: effects on size of hematomas and pain on injection.
OBJECTIVE
To determine whether use of a smaller needle size for subcutaneous injection of enoxaparin would reduce the size of injection-site hematomas and/or decrease the pain of injection.


METHODS
Prospective, randomized trial.


METHODS
Community hospital in North Vancouver, British Columbia, Canada.


METHODS
One hundred twenty-four patients with unstable angina or non-Q-wave myocardial infarction who were administered enoxaparin for anticoagulation.


METHODS
Each patient was randomly assigned to one of two groups. One group received enoxaparin injections with a 30-gauge, 5/16-inch insulin syringe, and the other group was injected with a 26-gauge, 3/8-inch tuberculin syringe.


RESULTS
Participating nurses used standard measuring tape to determine the largest diameter of each hematoma. Pain was assessed with a 10-unit numeric scale. The two groups did not differ significantly with regard to either the mean size of the largest hematoma/patient (4.2 cm in the insulin-syringe group vs 3.8 cm in the tuberculin-syringe group, p=0.68) or the mean pain score (0.3 in the insulin-syringe group vs 0.5 in the tuberculin-syringe group, p=0.10).


CONCLUSIONS
Use of a 30-gauge, 5/16-inch insulin syringe instead of a 26-gauge, 3/8-inch tuberculin syringe does not significantly reduce either hematoma size or pain of injection. A larger study is required to determine whether needle size affects the frequency of hematoma formation.
Robb
Dawn M
DM
Pharmacy Department, Lions Gate Hospital, North Vancouver, British Columbia, Canada.
Kanji
Zahra
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications / Q000188:drug therapy; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D017984:Enoxaparin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006406:Hematoma / Q000139:chemically induced* / Q000473:pathology*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy; D009339:Needles; D010146:Pain / Q000139:chemically induced* / Q000473:pathology*; D011446:Prospective Studies; D016896:Treatment Outcome
D000925:Anticoagulants; D017984:Enoxaparin