title: A Randomized Controlled Trial on the Effect of Needle Gauge on the Pain and Anxiety Experienced during Radial Arterial Puncture.
abstract: BACKGROUND
  Arterial punctures for assessment of arterial blood-gases can be a painful procedure. Lidocaine can be used to reduce pain prior to needle insertion but it is not a widely accepted practice. The purpose of this study was to determine whether a large size needle induces more pain compared to a smaller size needle for radial arterial puncture and to assess the anxiety associated with radial arterial punctures.
  
  
  METHODS
  We conducted a prospective, double-blind, randomized, controlled, monocentric study including all outpatients who had a planned assessment of arterial blood gas analysis. Patients were randomized to have the arterial puncture performed with a 23 or a 25 G needle. The main judgement criteria was pain during arterial puncture. Visual analogue scale for pain (VAS-P) and visual analogue scale for anxiety (VAS-A) were used to assess pain and anxiety during radial arterial puncture.
  
  
  RESULTS
  Two hundred consecutive patients were randomized. The 25 G needle was as painful as the 23 G needle (6.63 mm [0-19 mm] vs. 5.21 mm [0-18.49 mm], respectively, p = 0.527). Time for arterial puncture was longer with the 25 G needle than with the 23 G needle (42 s [35-55 s] vs. 33 s [24.5-35 s], respectively, p = 0.002). There was a correlation between the level of anxiety prior to the arterial puncture and the pain experienced by the patients (p: 0.369, p<0.0001). There was a correlation between the pain experienced by patients and the anxiety experienced in anticipation of another arterial puncture (p: 0.5124, p<0.0001).
  
  
  CONCLUSIONS
  The use of 23 G needle allows quicker arterial sampling and is not associated with increased pain and symptoms. Anxiety was correlated with the pain experienced by patients during arterial punctures.
  
  
  BACKGROUND
  Clinicaltrials.gov: NCT02320916.
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France; Groupe de Recherche sur le Handicap Ventilatoire, UPRES EA 3830, Haute-Normandie Institute of Biomedical Research and Innovation, Rouen University, Rouen, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Patout
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France; Groupe de Recherche sur le Handicap Ventilatoire, UPRES EA 3830, Haute-Normandie Institute of Biomedical Research and Innovation, Rouen University, Rouen, France.
authors.forename: Bouchra
authors.initials: B
authors.lastname: Lamia
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Lhuillier
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France.
authors.forename: Luis-Carlos
authors.initials: LC
authors.lastname: Molano
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Viacroze
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Benhamou
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France; Groupe de Recherche sur le Handicap Ventilatoire, UPRES EA 3830, Haute-Normandie Institute of Biomedical Research and Innovation, Rouen University, Rouen, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Muir
authors.affiliation: Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France; Groupe de Recherche sur le Handicap Ventilatoire, UPRES EA 3830, Haute-Normandie Institute of Biomedical Research and Innovation, Rouen University, Rouen, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Cuvelier
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology*; D001784:Blood Gas Analysis; D001800:Blood Specimen Collection / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles / Q000009:adverse effects*; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D017534:Radial Artery