title: Patient pain and tissue trauma during syringe procedures: a randomized controlled trial.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA.
authors.forename: Gautam R
authors.initials: GR
authors.lastname: Moorjani
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Michael
authors.forename: Andres
authors.initials: A
authors.lastname: Peisajovich
authors.forename: Kye S
authors.initials: KS
authors.lastname: Park
authors.forename: Wilmer L
authors.initials: WL
authors.lastname: Sibbitt
authors.forename: Arthur D
authors.initials: AD
authors.lastname: Bankhurst
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D007717:Knee; D007718:Knee Injuries / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain; D010147:Pain Measurement; D013396:Suction / Q000009:adverse effects* / Q000295:instrumentation*; D013582:Synovial Fluid; D013594:Syringes / Q000009:adverse effects