Urimoto Genya, Suzuki Takeshi, Matsuda Mitsumasa, Ito Kenzi, Orihashi Yasushi, Suzuki Toshiyasu
Department of Anesthesiology, Tokai University School of Medicine, Kanagawa, Japan.
Division of Clinical Research, Kitasato University Hospital, Kanagawa, Japan.
Med Devices (Auckl). 2024 Feb 21;17:89-95. doi: 10.2147/MDER.S447188. eCollection 2024.
Multiple needle punctures during central venous line insertion can lead to serious complications. Needle deterioration owing to repeated punctures may be a major cause. We hypothesized that there is an optimal bevel angle for a back-cut point needle that is resistant to deterioration. In this study, we examined the effect of bevel angle differences in a back-cut point needle on needle tip deterioration caused by multiple punctures.
The resin target was punctured perpendicularly using back-cut point needles with three bevel angles (15°, 17°, and 19°; n=8 for each angle) at a speed of 200 mm/min. The same needle was used for ten consecutive punctures at different locations on the target. The force applied to the needle was recorded as puncture force. The puncture force waveform is bimodal. The second peak values, which formed the maximum values of puncture force, were the focus of the main analysis. We considered a 5% elevation from the first to the 10th puncture force as needle deterioration, and the average slope value of the regression line between the puncture number and puncture force was used. When the upper limit of the 95% confidence interval (CI) of the slope value was less than 0.008889, the needle was considered to be resistant to deterioration.
The slopes of the second peak values during 10 consecutive punctures for each bevel angle (15°, 17°, 19°) were 0.003011 ± 0.01085 [-0.006056, 0.012077], 0.006116±0.007431 [-0.000096, 0.012328], and 0.001515 ± 0.005783 [-0.003320, 0.006349], respectively (mean ± standard deviation [95% CI]). Only the 19° angle needle had a smaller upper limit of the 95% CI for a slope value of 0.008889.
The 19° bevel angle back-cut point needle was more resistant to deterioration than the 15° and 17° angle needles were.
中心静脉置管过程中的多次穿刺可能导致严重并发症。反复穿刺引起的针头磨损可能是主要原因。我们推测，对于背切尖端针存在一个能抵抗磨损的最佳斜面角度。在本研究中，我们研究了背切尖端针的斜面角度差异对多次穿刺导致的针尖磨损的影响。
使用具有三种斜面角度（15°、17°和19°；每个角度n = 8）的背切尖端针以200 mm/min的速度垂直穿刺树脂靶。同一根针在靶上的不同位置连续穿刺十次。施加在针上的力记录为穿刺力。穿刺力波形是双峰的。形成穿刺力最大值的第二个峰值是主要分析的重点。我们将第一次到第十次穿刺力升高5%视为针头磨损，并使用穿刺次数与穿刺力之间回归线的平均斜率值。当斜率值的95%置信区间（CI）上限小于0.008889时，该针被认为抗磨损。
每个斜面角度（15°、17°、19°）连续10次穿刺期间第二个峰值的斜率分别为0.003011±0.01085[-0.006056, 0.012077]、0.006116±0.007431[-0.000096, 0.012328]和0.001515±0.005783[-0.003320, 0.006349]（均值±标准差[95%CI]）。只有19°角度的针对于斜率值0.008889的95%CI上限较小。
19°斜面角度的背切尖端针比15°和17°角度的针更抗磨损。
