Dawn M Robb1, Zahra Kanji. 1. Pharmacy Department, Lions Gate Hospital, North Vancouver, British Columbia, Canada.
Abstract
STUDY 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. DESIGN: Prospective, randomized trial. SETTING:Community hospital in North Vancouver, British Columbia, Canada. PATIENTS: One hundred twenty-four patients with unstable angina or non-Q-wave myocardial infarction who were administeredenoxaparin for anticoagulation. INTERVENTION: 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. MEASUREMENTS AND MAIN 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.
RCT Entities:
STUDY 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. DESIGN: Prospective, randomized trial. SETTING: Community hospital in North Vancouver, British Columbia, Canada. PATIENTS: One hundred twenty-four patients with unstable angina or non-Q-wave myocardial infarction who were administered enoxaparin for anticoagulation. INTERVENTION: 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. MEASUREMENTS AND MAIN 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.
Authors: Sake J van der Wall; Frederikus A Klok; Paul L den Exter; Deisy Barrios; Raquel Morillo; Suzanne C Cannegieter; David Jimenez; Menno V Huisman Journal: Hemasphere Date: 2018-02-02