• Maxime Patout, Bouchra Lamia, Elodie Lhuillier, Luis-Carlos Molano, Catherine Viacroze, Daniel Benhamou, Jean-François Muir, and Antoine Cuvelier.
• Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France; Groupe de Recherche sur le Handicap Ventilatoire, UPRES EA 3830, Haute-Normandie Institute of Biomedical Research and Innovation, Rouen University, Rouen, France.
• Plos One. 2015 Jan 1; 10 (9): e0139432.

BackgroundArterial punctures for assessment of arterial blood-gases can be a painful procedure. Lidocaine can be used to reduce pain prior to needle insertion but it is not a widely accepted practice. The purpose of this study was to determine whether a large size needle induces more pain compared to a smaller size needle for radial arterial puncture and to assess the anxiety associated with radial arterial punctures.MethodsWe conducted a prospective, double-blind, randomized, controlled, monocentric study including all outpatients who had a planned assessment of arterial blood gas analysis. Patients were randomized to have the arterial puncture performed with a 23 or a 25 G needle. The main judgement criteria was pain during arterial puncture. Visual analogue scale for pain (VAS-P) and visual analogue scale for anxiety (VAS-A) were used to assess pain and anxiety during radial arterial puncture.ResultsTwo hundred consecutive patients were randomized. The 25 G needle was as painful as the 23 G needle (6.63 mm [0-19 mm] vs. 5.21 mm [0-18.49 mm], respectively, p = 0.527). Time for arterial puncture was longer with the 25 G needle than with the 23 G needle (42 s [35-55 s] vs. 33 s [24.5-35 s], respectively, p = 0.002). There was a correlation between the level of anxiety prior to the arterial puncture and the pain experienced by the patients (p: 0.369, p<0.0001). There was a correlation between the pain experienced by patients and the anxiety experienced in anticipation of another arterial puncture (p: 0.5124, p<0.0001).ConclusionsThe use of 23 G needle allows quicker arterial sampling and is not associated with increased pain and symptoms. Anxiety was correlated with the pain experienced by patients during arterial punctures.Trial RegistrationClinicaltrials.gov: NCT02320916.

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