Asai T, Hidaka I, Kawashima A, Miki T, Inada K, Kawachi S
Department of Anaesthesia, Matsue Red Cross Hospital, Matsue City, Shimane, 690-8506, Japan.
Anaesthesia. 2002 Jun;57(6):572-7. doi: 10.1046/j.1365-2044.2002.02571.x.
There has been considerable interest in using safeguarded needles to reduce needlestick injury. In a randomised design, we studied the efficacy and safety of two such needles (the Insyte AutoGuard and the Protective Acuvance), by comparing them with a conventional catheter needle (Insyte), for intravenous cannulation (18 G) in 150 patients and for intra-arterial cannulation in another 150 patients (20 G). For intravenous cannulation, the success rates were similar in the three groups but insertion of the AutoGuard or Acuvance catheter was significantly more difficult than the conventional catheter. For the Acuvance, the back-flow of blood into the chamber was sometimes too slow. For intra-arterial cannulation, insertion of the AutoGuard was significantly more difficult than the other two devices, mainly because the backflow chamber of the AutoGuard was too short so that the chamber often filled with blood before cannulation. Insertion of the Acuvance was significantly more difficult than the conventional catheter. For both intravenous and intra-arterial insertion, handling of the withdrawn needle was judged significantly safer in the AutoGuard group than the other two groups, whereas there was no significant difference in the safety between the Acuvance and conventional groups. In five subjects from the AutoGuard group, blood splashed on retraction of the needle. Blood contamination during needle withdrawal occurred frequently in the control and Acuvance groups, but rarely occurred in the AutoGuard group. Therefore, the AutoGuard needle is more suitable for intravenous cannulation, and the Acuvance is more suitable for intra-arterial cannulation.
人们对使用安全防护针来减少针刺伤一直有着浓厚的兴趣。在一项随机设计中，我们研究了两种此类针（Insyte AutoGuard和Protective Acuvance）的有效性和安全性，将它们与传统的导管针（Insyte）进行比较，用于150例患者的静脉插管（18G）以及另外150例患者的动脉插管（20G）。对于静脉插管，三组的成功率相似，但AutoGuard或Acuvance导管的插入明显比传统导管困难。对于Acuvance，血液回流到腔室中的速度有时过慢。对于动脉插管，AutoGuard的插入明显比其他两种装置困难，主要是因为AutoGuard的回流腔太短，以至于在插管前腔室常常充满血液。Acuvance的插入明显比传统导管困难。对于静脉和动脉插入，在AutoGuard组中，拔出针的操作被判定比其他两组明显更安全，而Acuvance组和传统组之间在安全性上没有显著差异。在AutoGuard组的五名受试者中，拔针时血液溅出。对照组和Acuvance组在拔针过程中血液污染频繁发生，但AutoGuard组很少发生。因此，AutoGuard针更适合静脉插管，而Acuvance更适合动脉插管。
