title: Physician control of needle and syringe during aspiration-injection procedures with the new reciprocating syringe.
abstract: OBJECTIVE
  To evaluate physician control of needle and syringe during aspiration-injection syringe procedures by comparing the new reciprocating procedure syringe to a traditional conventional syringe.
  
  
  METHODS
  Twenty-six physicians were tested for their individual ability to control the reciprocating and conventional syringes in typical aspiration-injection procedures using a novel quantitative needle-based displacement procedure model. Subsequently, the physicians performed 48 clinical aspiration-injection (arthrocentesis) procedures on 32 subjects randomized to the reciprocating or conventional syringes. Clinical outcomes included procedure time, patient pain, and operator satisfaction. Multivariate modeling methods were used to determine the experimental variables in the syringe control model most predictive of clinical outcome measures.
  
  
  RESULTS
  In the model system, the reciprocating syringe significantly improved physician control of the syringe and needle, with a 66% reduction in unintended forward penetration (p < 0.001) and a 68% reduction in unintended retraction (p < 0.001). In clinical arthrocentesis, improvements were also noted: 30% reduction in procedure time (p < 0.03), 57% reduction in patient pain (p < 0.001), and a 79% increase in physician satisfaction (p < 0.001). The variables in the experimental system--unintended forward penetration, unintended retraction, and operator satisfaction--independently predicted the outcomes of procedure time, patient pain, and physician satisfaction in the clinical study (p < or = 0.001).
  
  
  CONCLUSIONS
  The reciprocating syringe reduces procedure time and patient pain and improves operator satisfaction with the procedure syringe. The reciprocating syringe improves physician performance in both the validated quantitative needle-based displacement model and in real aspiration-injection syringe procedures, including arthrocentesis.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA. wsibbitt@salud.anm.edu
authors.forename: Wilmer
authors.initials: W
authors.lastname: Sibbitt
authors.forename: Randy R
authors.initials: RR
authors.lastname: Sibbitt
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Michael
authors.forename: Druce I
authors.initials: DI
authors.lastname: Fu
authors.forename: Hilda T
authors.initials: HT
authors.lastname: Draeger
authors.forename: Jon M
authors.initials: JM
authors.lastname: Twining
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Bankhurst
mesh_terms: D000328:Adult; D006804:Ergonomics; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D019152:Paracentesis / Q000295:instrumentation* / Q000379:methods; D012219:Rheumatology / Q000295:instrumentation* / Q000379:methods; D013396:Suction / Q000295:instrumentation* / Q000379:methods; D013582:Synovial Fluid; D013594:Syringes; D016896:Treatment Outcome