Small Syringe Research Articles

Ultrasound Contrast Agent Needle Priming: Impact on Sonographic Biopsy Needle Visibility in a Porcine Liver Model

PurposeThe visibility of biopsy needles in contrast-specific imaging mode can be improved by priming them with an ultrasound contrast agent (previously demonstrated in a phantom model/ex vivo). The purpose of this study was to validate this priming method in a porcine in vivo model.Materials and MethodsUsing a small syringe, full-core biopsy needles were primed with sulfur hexafluoride, an ultrasound contrast agent, with non-primed needles serving as controls (n = 30 + 30). Liver punctures were performed in a porcine model following intravenous administration of the same ultrasound contrast agent. Needle visibility, both in their entirety and at the tips, was evaluated in split-screen mode using contrast-specific imaging and B-mode (low mechanical index). The assessment included quantitative analysis, calculating the contrast-to-noise ratio, and qualitative evaluation through structured grading by three radiologists.ResultsAfter needle priming, the contrast-to-noise ratio was superior for the needle in its entirety in contrast-specific imaging mode (p < 0.001) and slightly inferior in B-mode (p = 0.008). No differences were observed for the needle tips in either imaging mode. Qualitatively, the needle visibility was deemed clinically superior after needle priming throughout in contrast-specific imaging mode (p < 0.001), whereas no clinically relevant differences in B-mode for either the needle in its entirety (p = 0.11) or the needle tip (p = 1) were observed.ConclusionIn this in vivo porcine liver model experiment, priming biopsy needles with ultrasound contrast agent improved needle visibility in contrast-specific imaging mode but slightly reduced it in B-mode. These findings support the method’s use for biopsies requiring target visualization in contrast-specific imaging mode.No level of evidence.Graphical

Ecological tips to reduce waste during acetic acid dye application for Barrett's esophagus evaluation: a small syringe in the accessory channel is enough!

Ecological tips to reduce waste during acetic acid dye application for Barrett's esophagus evaluation: a small syringe in the accessory channel is enough!

Open-source 3-D printable autoinjector: Design, testing, and regulatory limitations.

Autoinjectors have become popular modern injectable medical devices used as drug delivery systems. Due to their ease, capability and reliability compared to other conventional injectable medical devices, the market and manufacturing demand for autoinjector devices are increasing rapidly and expected to reach a market of $37.5 billion globally by 2025. Although autoinjectors can offset healthcare treatment costs through self-administered medication, they can be expensive for consumers, which limit their accessibility. This study describes the design and manufacture of a spring-driven and 3-D printed autoinjector to overcome this economic accessibility challenge. The digitally replicable device is released as open-source hardware to enable low-cost distributed manufacturing. The bill of materials and assembly instructions are detailed, and the effectiveness of the autoinjector is tested against the current standard (ISO 11608-1:2022) for needle-based injection systems. The safety and dosing accuracy was tested by measuring the weight of 100% ethyl alcohol expelled from six BD Insulin syringes with varying capacities or needle lengths. A one-way analysis assessed the variability between the dose delivery efficiency of 1mL, 0.5mL, and 0.3mL syringes. Testing indicated that the entire dose was delivered over 97.5% of the time for 1mL and 0.5mL syringes, but the autoinjector's loaded spring force and size exceeded structural limitations of 0.3mL or smaller syringes. Components can be manufactured in about twelve hours using an open-source desktop RepRap-class fused filament 3-D printer. The construction requires two compression springs and 3-D printed parts. The total material cost of CAD$6.83 is less than a tenth of comparable commercial autoinjectors, which makes this approach promising. The autoinjector, however, is a class two medical device and must be approved by regulators. Future work is needed to make distributed manufacturing of such medical devices feasible and reliable to support individuals burdened by healthcare costs.

Ultrasound Contrast Agent Priming of Biopsy and Introducer Needles by Using a Small Syringe to Improve Needle Visibility in a Phantom Model

PurposeBiopsy under the guidance of contrast-enhanced ultrasound is sometimes useful. Needle visualization in contrast-specific imaging-mode is often poor; however, it may be improved by priming the needles with an ultrasound contrast agent. This study aimed to evaluate needle priming methods using the ultrasound contrast agent sulfur hexafluoride and a 1 mL syringe.Material and MethodsTwo kinds of biopsy needles, side-notch and full core, and one kind of introducer needle were primed using non-primed needles as controls (n = 180). Recordings of punctures were performed in a water bath phantom to which the ultrasound contrast agent had also been added. Contrast-specific imaging-mode needle visibility was evaluated for the entire needles and the needle tips, respectively, quantitatively by calculating the contrast-to-noise ratio and qualitatively via grading by three radiologists.ResultsThe contrast-to-noise ratio following the ultrasound contrast agent priming was superior compared to the controls for the entire needles of all three types (p < 0.001) and for the needle tips of the core biopsy needles and introducer needles (p < 0.001). However, the ratio was equal to the controls for the needle tips of the side-notch biopsy needles (p = 0.19). Needle visibility following the ultrasound contrast agent priming was qualitatively superior compared to the controls for both the entire needles and the needle tips, and the difference was considered clinically relevant by the assessors (p < 0.001).ConclusionThe ultrasound contrast agent needle priming methods described increased the contrast-specific imaging-mode needle visibility in a phantom model. Nonetheless, the results also need to be confirmed in vivo.

All-Optical, Air-Coupled Ultrasonic Detection of Low-Pressure Gas Leaks and Observation of Jet Tones in the MHz Range

We used an ultrasensitive, broadband optomechanical ultrasound sensor to study the acoustic signals produced by pressurized nitrogen escaping from a variety of small syringes. Harmonically related jet tones extending into the MHz region were observed for a certain range of flow (i.e., Reynolds number), which is in qualitative agreement with historical studies on gas jets emitted from pipes and orifices of much larger dimensions. For higher turbulent flow rates, we observed broadband ultrasonic emission in the ~0–5 MHz range, which was likely limited on the upper end due to attenuation in air. These observations are made possible by the broadband, ultrasensitive response (for air-coupled ultrasound) of our optomechanical devices. Aside from being of theoretical interest, our results could have practical implications for the non-contact monitoring and detection of early-stage leaks in pressured fluid systems.

10 clinical tips for advancing patient safety when using syringe pump systems for microinfusion intravenous drug therapy.

10 clinical tips for advancing patient safety when using syringe pump systems for microinfusion intravenous drug therapy.

Comparison of Dosing Accuracy Between the ENFit LDT and a Neonatal-Specific ISO-Compliant Enteral Syringe.

To evaluate the dosing accuracy of 2 female enteral syringe types for use in neonates. This was an in vitro study evaluating dosing accuracy of ENFit with low dose tip (LDT) and Nutrisafe2 (NS2) syringes. Acceptable dosing variance (DV) was +/- 10%. Outcomes included tests exceeding 10% DV and DV by syringe size, dispensing source, and intended dosing volume. A total of 300 tests were performed (LDT = 150, NS2 = 150) with 3 syringe sizes (0.5, 1, 3 or 2.5 mL). Compared with NS2, LDT had significantly more tests with unacceptable DV (48% vs 4.7%, p < 0.0001) and higher absolute DV (11.9% vs 3.5%, p < 0.001). Dosing variance was inversely proportional to syringe size, where the smallest syringes were least accurate (0.5 mL LDT 16.1% vs 4.6%, p < 0.001). The largest syringes had acceptable DV (3 mL LDT 8.8% vs 2.5 mL NS2 3.3%, p < 0.001). Bulk bottle with adapters demonstrated a higher DV with LDT compared with NS2 (13.3% vs 3.9%, p < 0.001). Medication cups without adapters were associated with acceptable DV for both LDT and NS2 (9.7% vs 2.9%, p < 0.001). The Nutrisafe2 syringe has greater dosing accuracy as compared with ENFit LDT syringe. Smaller syringes are associated with greater dosing inaccuracy, but this effect was within acceptable DV for the NS2 syringe. Bulk bottle adapters did not improve the accuracy of the LDT. More clinical evaluations are needed to determine if the ENFit can be safely used in the neonatal population.

Diapausing insects don't like it hot

Many insects undergo phases when they become inactive and dormant – known as diapause – to survive harsh seasons, such as winter or dry periods. They switch off or dramatically slow growth and metabolism, which ultimately reduces their energy demands. Diapausing insects mostly rely on daylength and temperature to anticipate and get properly geared up for the arrival of harsh conditions. Whether or not climate change is driven by human activity, there is little doubt that global warming represents a new hurdle for many seasonal organisms to overcome. Research has already shown that warm winters can reduce the mass, survival and fecundity of several diapausing insects. However, organisms need to enter diapause some time before the onset of inhospitable conditions and a much less explored question is what happens when they cannot best figure out when winter will actually begin.Matthew Nielsen from the University of Stockholm, Sweden, with colleagues from Stockholm University and Greifswald University, Germany, was interested in finding out whether warmer or longer pre-winter conditions have an impact on the survival of diapausing insects. To test this, they exposed diapausing pupae of the green-veined white butterfly (Pieris napis) – which is widespread throughout much of Europe and Asia – to different pre-winter temperatures (ranging from a mild 15°C to what would be considered an extremely warm 25°C in their natural environment) for different durations (from 1 to 16 weeks). Then all of the butterflies experienced the same standardised winter conditions (2°C) for 24 weeks, followed by two consecutive weeks at 17°C to simulate spring and induce the emergence of the adults from their pupal cases. The researchers tracked how the pupae's masses varied at regular intervals for up to 42 weeks, as well as their survival. In addition, they also assessed changes in the metabolic rates of a group of the insects during the pre-winter period by placing each pupa in a sealed small syringe to measure how much CO2 they exhaled.The team found that warmth in the run up to winter led to a substantial loss of mass in diapausing butterflies and this loss became greater as the pre-winter periods grew longer. The leaner insects also experienced higher metabolic rates during pre-winter, likely caused by an increase in their energy expenditures to cope with the heat. Yet, although these conditions did not lead to higher death rates in the pupae in the run up to winter, their impact became clear after winter, with fewer of the pupae that had experienced longer and warmer pre-winters surviving to become adults. However, the butterflies that managed to survive winter after experiencing a long warmer pre-winter were leaner, suggesting that these adults were probably less well prepared for life in the future.In summary, Nielsen's study suggests that a warmer climate may challenge the fate of seasonal organisms and that longer warmer pre-winters could reduce the survival of overwintering insects. The study also highlights the importance of studying the impact of climate change over the entire life cycle of an organism as conditions experienced at one point in life can have delayed effects at later stages.

Contrived Breathing Circuit Connection for Emergency Percutaneous Transtracheal Ventilation by Needle Cricothyrotomy in the Field.

Surgical airway approaches are, at times, last resort options in difficult airway management. In Special Operations these interventions confront distorted anatomy from combat trauma, extreme conditions, and may be performed by non-medically trained personnel. Under these circumstances, needle cricothyroidotomy using a large bore intravenous catheter can be considered. A small syringe connected to the needle can confirm transtracheal placement through air aspiration before passing the angiocatheter over the needle. Button activated retracting needles should be avoided for this when possible. We recommend a 3-mL Luer-lock syringe because a small syringe is better suited for generating pressure and once the catheter is in the trachea, this same syringe can be connected to bag valve ventilation by replacing its plunger with a connector from a 6.5-, 7-, or 7.5-mm endotracheal tube. Adding these small and light high-yield items to the Tactical Combat Casualty Care medic inventory should be considered in future revisions.

Slosh Simulation in a Computer Model of Canine Syringomyelia.

The exact pathogenesis of syringomyelia is unknown. Epidural venous distention during raised intrathoracic pressure (Valsalva) may cause impulsive movement of fluid (“slosh”) within the syrinx. Such a slosh mechanism is a proposed cause of syrinx dissection into spinal cord parenchyma resulting in craniocaudal propagation of the cavity. We sought to test the “slosh” hypothesis by epidural excitation of CSF pulse in a computer model of canine syringomyelia. Our previously developed canine syringomyelia computer model was modified to include an epidural pressure pulse. Simulations were run for: cord free of cavities; cord with small syringes at different locations; and cord with a syrinx that was progressively expanding caudally. If small syringes are present, there are peaks of stress at those locations. This effect is most pronounced at the locations at which syringes initially form. When a syrinx is expanding caudally, the peak stress is typically at the caudal end of the syrinx. However, when the syrinx reaches the lumbar region; the stress becomes moderate. The findings support the “slosh” hypothesis, suggesting that small cervical syringes may propagate caudally. However, when the syrinx is large, there is less focal stress, which may explain why a syrinx can rapidly expand but then remain unchanged in shape over years.

Trend of Intravitreal Bevacizumab Dispensing Technique in Nepal.

The main purpose of this survey was to find out what technique for bevacizumab injection is practiced by ophthalmologists in Nepal and to evaluate which is the best technique of drug dispensing and what possible hindrances are there in following it. This was an online survey using google forms. There were a total of 34 participants in the survey. Most of the participants (58.8%) followed the same vial, multiple prick, multiple days method for giving intravitreal bevacizumab.. Majority of participants said they thought that aliquoting the drug and using it same day would be the best technique to prevent post injection endophthalmitis. Cost and unsuitability for small hospitals were the main factor preventing surgeons from practicing the best method. Risk of endophthalmitis can be reduced by following proper drug dispensing techniques. Aliquoting bevacizumab in smaller syringes under aseptic conditions can reduce the risk of endophthalmitis.

Rupture of an epidural filter connector during bolus administration of local anesthetic: a case report

BackgroundEpidural catheters are routinely placed for many surgical procedures and to treat various pain conditions. Known complications arising from epidural catheter equipment malfunction include epidural pump failure, epidural catheter shearing, epidural catheter connector failure, epidural filter connector cracking, and loss-of-resistance syringe malfunction. Practitioners need to be aware of these potentially dangerous complications and take measures to mitigate the chances of causing significant patient harm. We report on the complete breakage of an epidural filter connector during epidural bolus administration of local anesthetic by hand with a syringe.Case presentationA B. Braun Perifix® epidural catheter was placed in a 73-year-old male scheduled for radical prostatectomy. During the operation, a continuous infusion of local anesthetic was administered through the epidural catheter in addition to general endotracheal anesthesia. At the conclusion of surgery and after extubation, the patient endorsed incisional pain. The epidural filter connector broke in half as a bolus of local anesthetic was administered by hand with a syringe. The local anesthetic sprayed widely throughout the room as the fragmented epidural filter connector became a projectile object that recoiled and struck the patient.ConclusionsThis incident placed the patient and surrounding healthcare providers at substantial risk for injury and infection from the fractured epidural filter connector becoming a projectile object and from the local anesthetic spray. The most plausible cause of this event was from a large amount of pressure being applied to the filter connector. This may have occurred by excessive force being applied by hand to the syringe, by the presence of a clogged filter, or by the catheter being kinked or blocked proximal to the filter. Being aware of this deleterious complication and potentially modifying existing epidural bolus techniques, such as using smaller syringes with less applied force and checking all epidural components vigilantly prior to and during bolus administration, can help anesthesia providers deliver the safest possible care to patients with epidural catheters.

Improving graphene gas sensors via a synergistic effect of top nanocatalysts and bottom cellulose assembled using a modified filtration technique

Improving graphene properties with nanosized catalysts is of interest for numerous applications, especially chemical sensors. Thus, the aim of this study is to prepare nanocatalysts and assemble them on reduced graphene oxide (RGO) for sensing nitric oxides (NOx). The nanocatalysts used in this study include TiO2 nanoparticles (commercial) with WO3, WS2, and MoS2 nanoflakes (mechanically synthesized). Their decoration on the RGO active channel (forming nanohybrids) was obtained via a modified vacuum filtration technique, in which a small syringe and USB-powered pump were employed to surmount the limitation of the conventional filtration setup in the patternable fabrication of device arrays. Sensing measurements expose a co-effect of the nanocatalysts and the cellulose substrate on our RGO-based paper sensors. That can boost the sensitivity of RGO toward NO (1-10 ppm) and NO2 (0.7–3.5 ppm) but weaken it toward NH3 (2–20 ppm). Particularly among the nanocatalysts, MoS2 nanoflakes made our RGO nanohybrid possessing the fastest response/recovery and the highest selectivity toward NOx at room temperature (25 °C). Generally, this study reveals the synergistic effect of MoS2 and cellulose substrate on the improvement of RGO sensing ability and confirms the aptitude of our sensors for flexible and disposable NOx sensing applications.

Surgical Pearl: Small Suction Syringe for Producing Blister

Surgical Pearl: Small Suction Syringe for Producing Blister

Creation of a Custom-Length, Humeral Antibiotic Cement Spacer for Use in Treatment of Shoulder Periprosthetic Joint Infection

Periprosthetic joint infection of the shoulder is a challenging clinical situation to manage owing to the fastidious organisms often present and delayed clinical presentation. While several treatment options have been described, the mainstay of treatment remains a staged revision with the use of a humeral antibiotic cement spacer. Such spacers are commercially available or can be made by hand. When an extended humeral osteotomy is required to remove a well-fixed long stem humeral component, it may be advantageous to place an antibiotic spacer with a stem length approximately as long as the hardware being removed. This technique demonstrates creation of a custom length, humeral antibiotic cement spacer for use in treatment of shoulder periprosthetic joint infection.

3D-printed lab-in-a-syringe voltammetric cell based on a working electrode modified with a highly efficient Ca-MOF sorbent for the determination of Hg(II)

This work combines, for the first time, 3D-printing technology and a highly efficient metal organic framework (Ca-MOF) as an electrode modifier to produce a novel fully integrated lab-in-a-syringe device for the sensitive determination of Hg(II) by anodic stripping voltammetry. The specific Ca-MOF ([Ca(H4L)(DMA)2]·2DMA where H6L is the N,N’-bis(2,4-dicarboxyphenyl)-oxalamide and DMA is the N,N-dimethylacetamide) shows an exceptional Hg(II) sorption capability over a wide pH range and its mechanism is elucidated via spectroscopic and X-ray diffraction studies. The voltammetric lab-in-a-syringe device is fabricated through a single-step process using a dual extruder 3D printer and is composed of a vessel integrating two thermoplastic conductive electrodes (serving as the counter and pseudo-reference electrodes) and of a small detachable 3D-printed syringe loaded with a graphite paste/Ca-MOF mixture (which serves as the working electrode). After optimization of the fabrication and operational variables, a limit of detection of 0.6 μg L−1 Hg(II) was achieved, which is comparable or lower than that of existing sensors (plastic 3D-printed, gold and MOF-based electrodes). The adoption of 3D printing technology in combination with the highly efficient Ca-MOF enables the fabrication of a simple, low-cost and sensitive electrochemical sensor for Hg(II), which is suitable for on-site applications.

Effect of stellate ganglion block versus intraluminal application of verapamil-nitroglycerine solution on internal mammary artery graft blood flow rate in patients undergoing on-pump coronary artery bypass grafting

Background Left internal mammary artery (IMA) graft is the most promising arterial conduit for coronary artery bypass grafting. Stellate ganglion block (SGB) induces sympathetic blockade and is used to prevent or control spasm of the internal mammary artery. The purpose of this study was to investigate the effect of left SGB on left IMA blood flow rate. Patients and methods A total of 170 patients aged between 65 and 70 years, with American Association of Anesthesiologists physical status II and III, and scheduled for elective coronary artery bypass grafting, were randomly allocated to either a SGB group or a verapamil-nitroglycerine group. In the SGB group, the patients received SGB using 8 ml of bupivacaine 0.25%. In the verapamil-nitroglycerine group, the patients received intraluminal injection of the harvested IMA graft with a solution, containing verapamil 5 mg, nitroglycerine 2.5 mg, heparin 500 U, 8.4% NAHCO3 0.2 ml, and ringer solution 40 ml, throughout its whole length using a small syringe, and with a low dose of intravenous nicardipine infusion started after harvesting (5 mg nicardipine in 100 ml saline at a rate of 0.5 mg or 10 ml/h). IMA blood flow rate (primary outcome), abnormal ECG changes, ICU length of stay, intra-aortic balloon usage, pre–postoperative pulse rate and blood pressure, incidence of atrial fibrillation, radio-femoral arterial pressure difference, pre–postoperative ejection fraction, need for re-exploration, and mortality rate were observed. Results This prospective study showed a significant increase of IMA blood flow rate (P Conclusion The results of this study showed that SGB prevents IMA spasm, increases its blood flow rate, and decreases incidence of atrial fibrillations compared with intraluminal injection of verapamil and nitroglycerine combined with intravenous nicardipine.

Dosing Errors Made by Paramedics During Pediatric Patient Simulations After Implementation of a State-Wide Pediatric Drug Dosing Reference

Background: Drug dosing errors occur at a high rate for prehospital pediatric patients. To reduce errors, Michigan implemented a state-wide pediatric dosing reference (PDR), with doses listed in milliliters, the requirement that doses be drawn into a smaller syringe from a pre-loaded syringe using a stopcock, and dilution of certain drugs to different concentrations.Purpose: To evaluate the rate of medication errors, including errors of omission and commission, after implementation of a state-wide PDR.Methods: EMS crews from 15 agencies completed 4 validated, simulation scenarios: an infant seizing, an infant cardiac arrest, an 18-month-old with a burn, and 5-year-old with anaphylactic shock. Agencies were private, public, not-for-profit, for-profit, urban, rural, fire-based, and third service. EMS crews used their regular equipment and were required to carry out all the steps to administer a drug dose. Two evaluators scored crew performance via direct observation and video review. An error was defined as 20% difference compared to the weight-appropriate dose. Descriptive statistics were utilized.Results: A total of 142 simulations were completed. The majority of crews were (58.3%) Emergency Medical Technician-Paramedic (EMTP)/EMTP. For the cardiac arrest scenario, 51/70 (72.9%; 95% CI: 60.9%, 82.8%) epinephrine doses were correct. There were 6 (8.6%, 95% CI: 2.0%, 15.1%) 10-fold overdoses and one (1.4%; 95% CI: –1.4%, 4.2%), 10-fold under dose. In the seizure scenario, 28/50 (56.0%; 95% CI: 42.2%, 69.8%) benzodiazepine doses were correct; 6/18 (33.3%; 95% CI: 11.5%, 55.1%) drug dilutions were incorrect resulting in dosing errors. Unrecognized air was frequently entrained into the administration syringe resulting in under doses. Overall, 31.2% (95% CI: 25.5%, 36.6%) of drug doses were incorrect. Obtaining an incorrect weight led to a drug dosing error in 18/142 (12.7%, 95% CI: 7.2%, 18.2%) cases. Errors of omission included failure to check blood sugar in the seizure scenario and failure to administer epinephrine and a fluid bolus in anaphylactic shock.Conclusion: Despite implementation of a PDR, dosing errors, including 10-fold errors, still occur at a high rate. Errors occur with dilution and length-based tape use. Further error reduction strategies, beyond a PDR and that target errors of omission, are needed for pediatric prehospital drug administration.

Safe vincristine use in Switzerland: Still a long way to go?

Different international organizations recommend safety measures for the use of vincristine to prevent wrong route administrations. A central recommendation is to use infusion bags instead of syringes to prevent confusion with intrathecal chemotherapy. This study aimed to investigate the implementation of safety measures for vincristine and intrathecal chemotherapies in Switzerland. We conducted a written survey among hospital pharmacies of all general care and pediatric hospitals in Switzerland (n = 102). A responsible person of each hospital pharmacy was invited by email to participate in the online survey in May 2018. Of 66 responding hospitals (response rate 65%), 27 have a hospital pharmacy preparing parenteral chemotherapy. All of these hospitals prepared vincristine in 2017, while 21 also prepared intrathecal chemotherapy. Of these 21, 16 hospitals prepared vincristine as syringes, with small volume syringes being the most widely distributed dosage form. A switch from syringes to infusion bags was discussed in seven hospitals, and discussions led to plans for switch in two. The most prevalent safety measures were labeling for vincristine and special delivery for intrathecal drugs. Of hospitals preparing both vincristine syringes and intrathecal chemotherapy, four reported to have no safety measures implemented neither for vincristine nor for intrathecal chemotherapy. International recommendations are not widely implemented in Swiss hospitals. Syringes are still in use and other safety measures are sparsely disseminated. Thus, Swiss vincristine patients are still at an increased risk for wrong route application. Recommendations have to be further disseminated and implementation could be enhanced.

Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.