title: Comparison of pain tolerance thresholds of upper limb to identify the most appropriate venipuncture site.
abstract: OBJECTIVE
  Venipuncture is often accompanied by pain, which can compromise dental care and foment distrust toward dental care providers. The aim of the present study was to identify sites on the forearm and hand that have the greatest pain tolerance threshold (PTT) during venipuncture.
  
  
  METHODS
  The PTT was estimated in 20 healthy volunteers using a noninvasive nerve conduction threshold device. The subjects self-stimulated 5 sites (median cubital vein, cephalic vein at the cubitus, basilic vein, cephalic vein at the carpus, and superficial dorsal vein) at 2 kHz, 250 Hz, and 5 Hz. We measured the stimulation intensity before the subject deactivated the device. Differences in the average PTT values at each site were compared using the Kruskal-Wallis and Scheffé tests. P <.05 was considered to indicate statistical significance.
  
  
  RESULTS
  The PTT was significantly greater at the superficial dorsal vein than at the basilic vein for all 3 noninvasive nerve conduction threshold frequencies (P < .05). The estimated PTT was significantly greater at the superficial dorsal vein than at the median cubital vein and cephalic vein at the carpus in response to 250-Hz stimulation (P < .05).
  
  
  CONCLUSIONS
  The greater PTT of the superficial dorsal vein suggests that venipuncture at this site should result in the lowest pain intensity among all upper limb sites.
authors.affiliation: Assistant Professor, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan. Electronic address: mh.yoshida@gmail.com.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Associate Professor, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Shiiba
authors.affiliation: Assistant Professor, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Sago
authors.affiliation: Assistant Professor, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Nunomaki
authors.affiliation: Assistant Professor, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Harano
authors.affiliation: Professor and Department Head, Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D001132:Arm / Q000502:physiology*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D017288:Pain Threshold; D018962:Phlebotomy; D055815:Young Adult