Syringe Group Research Articles

A Pilot Study to Compare the Episure™ Autodetect™ Syringe with the Glass Syringe for Identification of the Epidural Space in Parturients

The Episure AutoDetect syringe, a spring-loaded syringe, is a new loss-of-resistance syringe with an internal compression spring that applies constant pressure on the plunger. In this pilot study, we compared the spring-loaded syringe with the standard glass syringe for identification of the epidural space during initiation of epidural analgesia in parturients. The primary outcome was the incidence of failed epidural analgesia. Three-hundred and twenty-five women were enrolled. Eight residents performed 291 procedures (90%) and two attendings performed 34 procedures (10%). Epidural analgesia failed in five subjects in the glass syringe group and in no subject in the spring-loaded syringe group (P = 0.025).

A comparison of the efficacy, tolerability, and convenience of two formulations of follitropin-α in Iranian woman undergoing intracytoplasmic sperm injection cycles

To compare the efficacy, tolerability, and convenience of two formulations of the follitropin-alpha (Gonal-f) pen device versus the conventional form in Iranian women undergoing ovarian stimulation for intracytoplasmic sperm injection. Randomized, single-center trial, parallel-group, single blind. Tertiary referral center, University Hospital. A total of 100 patients undergoing intracytoplasmic sperm injection. After down-regulation with busereline acetate, patients were randomized to receive the pen device or the conventional syringe of follitropin-alpha. A computer-generated randomization list was used to allocate the patients to one of these two groups. The primary outcomes were patients' satisfaction, convenience, occurrence of local tolerance symptoms, and pain. Total dose of follitropin-alpha, duration of follitropin-alpha treatment, number of oocyte retrieved, number of viable embryos, and clinical pregnancies were secondary outcome measures. Data collection was performed by means of a questionnaire designed for the purpose of this study. The pain scored according to the Visual Analogue Scale. Self-administration and patients' satisfaction were significantly higher in the pen device group than the conventional syringe group. Local reactions at injection sites and pain were significantly higher in the conventional syringe group than in the pen device group. There were no statistically differences in secondary outcome measures and convenience between two groups. Among the Iranian patients that we studied, the pen device of Gonal-f is safe, convenient, and less painful, with more patients' satisfaction than the conventional syringe form, but both forms have equal efficacy in intracytoplasmic sperm injection cycles.

Pain Associated With Local Anesthetic Injection in Eyelid Procedures: Comparison of Microprocessor-Controlled Versus Traditional Syringe Techniques

To evaluate the pain associated with local infiltration of the eyelid, using a microprocessor-controlled delivery system (CompuMed, using the Wand), as compared with traditional manual syringe infiltration technique. A randomized clinical trial of 30 patients undergoing minor eyelid surgical procedures was performed. Fifteen patients were injected by use of the CompuMed system and 15 patients were injected by the traditional manual syringe technique. The severity of pain was recorded from each patient by using a visual analog scale (0 to 10). The duration of pain experienced by the patient was also recorded. The mean pain level reported was 1.5 in the Wand group and 3.2 in the syringe group (p < 0.01). The mean duration of pain experienced was 1.5 seconds in the Wand group and 34 seconds in the syringe group (p < 0.01). The Wand was effective at significantly reducing the pain associated with local anesthetic infiltration in minor eyelid surgical procedures. Patients appear to feel pain from the initial needle stick but not during the actual injection.

Radiation Exposure to Operators during Vertebroplasty

To measure the radiation received by physicians during percutaneous vertebroplasty with use of two types of injection devices with the interventional equipment guided by computed tomography (CT) and an angiographic/CT system. Twenty consecutive patients who underwent percutaneous vertebroplasty were included in this study. The patients were divided into two groups, the 1-mL syringe group and the bone cement injector group. Percutaneous vertebroplasties were performed with the IVR-CT system, which combines angiographic and CT equipment with a single fluoroscopy table. Radiation dose to operators was measured as equivalent dose penetrating at a 10-mm tissue depth with use of electronic personal dosimeters attached outside and inside lead aprons. Effective radiation dose (HE) was estimated based on the radiation dose outside the lead apron (Ha) and the radiation dose inside the lead apron (Hb). Differences between the groups in doses and fluoroscopic duration were analyzed. In the 1-mL syringe group and bone cement injector group, mean Ha measurements were 320.8 microSv and 116.2 microSv, respectively. Mean Hb measurements were 14.5 microSv versus 7.8 microSv and mean HE measurements were 48.2 microSv versus 19.7 microSv. Significant differences were found in Ha, Hb, and HE. However, duration of fluoroscopy did not differ significantly between groups. Radiation dose was relatively high for operators performing percutaneous vertebroplasty. The bone cement injector was useful in reducing the level of radiation exposure to operators during vertebroplasty.

Follitropin Beta Administered by a Pen Device in Patients Undergoing Controlled Ovarian Hyperstimulation for IVF-ET

OBJECTIVE: To compare the efficacy and convenience of a pen device for the self-administration of follitropin beta with a conventional syringe delivering follitropin alpha solution in patients undergoing controlled ovarian hyperstimulation (COH) for IVF-ET. DESIGN: A prospective, randomized study. MATERIALS AND METHODS: A total of 100 patients who were scheduled for IVF-ET, with or without intracytoplasmic sperm injection (ICSI) were enrolled in this study. All subjects were randomized to the pen device group or the conventional syringe group by a computer-generated randomization list using random numbers on a first day of COH. Local tolerance reactions were assessed and filled in a local tolerance book within 5 min, at 1 and 3 hr after each injection. On the day of hCG injection, patients were asked to rate the pain and convenience experienced by means of a visual analogue scale (VAS). Oocyte pickup was scheduled 35-36 hours after hCG administration, and embryos were transferred 3 days after oocyte pickup. RESULTS: There were no differences in age, body mass index (BMI), infertility duration, endocrine profile and indications for IVF-ET/ICSI between the two groups. The duration of COH with recombinant FSH (rFSH) was significantly shorter in the pen device group than in the conventional syringe group (8.7 1.1 vs 9.3 1.3 days)(P 0.05). Patients included in the pen device group needed significantly less rFSH with 2091.0 318.8 IU compared with 2248.0 405.0 IU in the conventional syringe group (P 0.05). However, no differences between the two groups were found in numbers of oocytes retrieved, mature oocytes, fertilized oocytes and grade I/II embryos, clinical pregnancy rate and miscarriage rate. The prevalence of pain after the daily injection was significantly lower in the pen device group (P 0.05). VAS scores were significantly less painful and more convenient for the pen device (P 0.05, P 0.00l, respectively). CONCLUSION: The pen device for self-administration of follitropin beta is effective, safe, less painful and more convenient for the patients, and can be more beneficial because of the short-term and small dose application of rFSH. Supported by: Organon grant 2003-0219

Use of a fully automated injector for self-administration of follitropin α in an IVF/ICSI programme

Recombinant FSH (r-FSH) used for ovarian stimulation can currently be self-administered either by a conventional syringe or by a pen device. This randomized controlled trial compares the efficacy and convenience of a new, more sophisticated and fully automated injection device (SoftinjectTM) with the conventional syringe for r-FSH self-administration. A total of 300 women needing ovarian stimulation for IVF/intracytoplasmic sperm injection were randomized to the automated injector or the conventional syringe group. Patients of both groups had ovarian stimulation with follitropin α after pituitary desensitization with a gonadotrophin-releasing hormone agonist. State anxiety score, overall pain score and pregnancy rate were chosen as the main outcome measures. Patients in the automated injector group showed lower state anxiety ( P < 0.01) and overall pain ( P < 0.01) scores and a comparable pregnancy rate per started cycle as compared with the conventional syringe group. They needed lower doses of r-FSH ( P < 0.05) and their stimulation was shorter ( P < 0.05). It is concluded that the use of a fully automated injector for r-FSH self-administration reduces pain and stress as compared with the conventional syringe. This device can be used for any subcutaneously administered drug employed in ovarian stimulation.

Oral hypertonic glucose spray: a practical alternative for analgesia in the newborn

Pain and stress have been shown to induce significant physiological and behavioural reactions in newborn infants. Pharmacological agents are not recommended in neonates for pain relief in minor procedures. Since different sweet solutions given orally by syringe have been shown to relieve pain in neonates, we decided to compare the analgesic effects of a small dose of glucose solution given orally by spray and by syringe during heel lancing in term neonates, using a validated behavioural acute pain rating scale. Sixty hyperbilirubinaemic full-term neonates were studied. We used a randomized, masked, placebo-controlled, crossover trial. Each infant was assessed three times receiving 0.5 ml 30% glucose in spray form, 0.5 ml 30% glucose by syringe or 0.5 ml sterile water by syringe in random order, 2 min before heel lancing. Pain scores were significantly lower in the 30% glucose given either spray or syringe groups compared with the placebo group. No statistically significant difference in pain scores was found between the 30% glucose spray group and 30% glucose syringe group. A small dose of 0.5 ml 30% glucose spray has an equal analgesic effect to the same dose given by syringe. The spray form has the advantage of being easy to use and is well accepted by newborn babies.