A randomized, controlled trial of the reciprocating syringe in arthrocentesis

Hilda T. Draeger ^1*, Jon M. Twining ¹, Courtney R. Johnson ¹, Sharon C Kettwich ², Lawrence G. Kettwich ² and Arthur D. Bankhurst ¹

¹ University of New Mexico Health Sciences Center, United States
² University of New Mexico, United States

^* To whom correspondence should be addressed. E-mail: hdraeger31{at}aol.com.

Accepted 27 November 2005

Abstract

Objective: To evaluate the outcomes of arthrocentesis with the new highly controllable, one- handed reciprocating procedure syringe compared to a conventional syringe.

Methods: 100 arthrocentesis procedures were randomized between the reciprocating syringe and the conventional syringe. Outcome measures included patient pain, procedure duration, operator satisfaction, synovial fluid volume, cell counts, and complications.

Results: 50 arthrocentesis procedures with the conventional syringe resulted in a mean procedure time of 3.39± 1.88 minutes, a mean VAPS (patient pain) score of 5.35 ± 3.15, and a mean VASS (operator satisfaction) score of 4.88± 1.92. 30/50 subjects experienced moderate to severe pain (VAPS score 5 or greater) during arthrocentesis. In contrast, the reciprocating syringe resulted in a reduced procedure time of 1.94± 1.14 minutes (p<0.001), a reduced VAPS (patient pain) score of 2.54± 1.60 (p<0.001), and an increased VASS (operator satisfaction) score of 8.91± 0.79 (p<0.001). Only 5/50 of subjects experienced moderate to severe pain with the reciprocating syringe. Synovial cell counts were similar between the two syringes (p > 0.05), but there was a trend toward greater volume (greater synovial fluid yield) and fewer red blood cells with the reciprocating syringe.

Conclusions: Arthrocentesis with a conventional syringe results in moderate to severe pain in 60% of subjects. The reciprocating syringe prevents significant pain, reduces procedure time, and improves physician performance of arthrocentesis. The reciprocating syringe is superior to the conventional syringe in arthrocentesis.

Keywords: Arthrocentesis, joint, procedure, reciprocating, syringe

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