• Anthony Chauvin, Nicolas Javaud, Aiham Ghazali, Sonja Curac, Adrien Altar, Talina Ali, Nora Beguin, Julien Bellier, Antoine Coupier, Laura Delsarte, Dora Dreyfuss, Nour Kheirbek, Clara Oudar, Yoann Stordeur, Morgane Weiss, Stephane Gaudry, Jerome Lambert, and Damien Roux.
• Emergency Department, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, Paris, France.
• Emerg Med J. 2020 Dec 1; 37 (12): 756-761.

IntroductionVenous sampling for blood gas analysis has been suggested as an alternative to arterial sampling in order to reduce pain. The main objective was to compare pain induced by venous and arterial sampling and to assess whether the type of sampling would affect clinical management or not.MethodsWe performed an open-label randomised multicentre prospective study in four French EDs during a 4-week period. Non-hypoxaemic adults, whose medical management required blood gas analysis, were randomly allocated using a computer-generated randomisation list stratified by centres with an allocation ratio of 1:1 using random blocks to one of the two arms: venous or arterial sampling. The primary outcome was the maximal pain during sampling, using the visual analogue scale. Secondary outcomes pertained to ease of sampling as rated by the nurse drawing the blood, and physician satisfaction regarding usefulness of biochemical data.Results113 patients were included: 55 in the arterial and 58 in the venous sampling group. The mean maximal pain was 40.5 mm±24.9 mm and 22.6 mm±20.2 mm in the arterial group and the venous group, respectively, accounting for a mean difference of 17.9 mm (95% CI 9.6 to 26.3) (p<0.0001). Ease of blood sampling was greater in the venous group as compared with the arterial group (p=0.02). The usefulness of the results, evaluated by the prescriber, did not significantly differ (p=0.25).ConclusionsVenous blood gas is less painful for patients than ABG in non-hypoxaemic patients. Venous blood gas should replace ABG in this setting.Trial Registration NumberNCT03784664.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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