An observational study of the effect of dilution and delivery speed on the development of phlebitis after epirubicin chemotherapy

Abstract

Aim Epirubicin causes venous irritation when administered through a peripheral cannula. The aim of this study was to identify if the speed of administration and/or volume of 0.9% saline used during epirubicin administration influences the development of chemical phlebitis in patients with breast cancer.Method Perceptions of 27 chemotherapy nurses of how administration technique may influence development of chemical phlebitis were collated from a questionnaire. Between August 2017 and May 2018, 120 cycles of epirubicin were observed and administration speed and volume of saline used during administration were recorded. Phlebitis signs and symptoms were graded by staff using a phlebitis severity scale and patients completed a questionnaire.Results Most chemotherapy nurses believed that administering a large volume of fluid during epirubicin and flushing afterwards were helpful in preventing phlebitis, but there was no consensus on the benefits of rapid or slow infusion speeds. Observation data analysed using SPSS v24 demonstrated no significant influence on the severity of phlebitis for administration speed (P=0.617) or volume of saline (P=0.879). Administration pain was associated with a significantly higher incidence of phlebitis (P=0.001).Conclusion Ensuring a concentration of <3mg/mL could reduce the risk of pain during administration.