A short bevel needle with a very thin tip improves vein puncture performance of peripheral intravenous catheters: An experimental study

Abstract

Background: Peripheral intravenous catheter placement is frequently unsuccessful at the first attempt. One suggested risk factor is a small vein size, because of the consequences of mechanical forces generated by the needle tip. We developed short bevel needles with a very thin tip and evaluated their puncture performance in two in vitro models. Methods: Peripheral intravenous catheters with a new needle ground using the lancet method (experimental catheter (L)) or backcut method (experimental catheter (B)) were compared with a conventional peripheral intravenous catheter (Surshield Surflo®) in a penetration force test and a tube puncture test. Penetration forces were measured when peripheral intravenous catheters penetrated a polyethylene sheet. The tube puncture test was used to evaluate whether the peripheral intravenous catheters could puncture a polyvinyl chloride tube at two positions, at the center and at 0.5 mm from the center of the tube. Results: Mean penetration forces at the needle tip produced by experimental catheters (L) (0.05 N) and (B) (0.04 N) were significantly lower than those produced by the conventional catheter (0.09 N) (p < 0.01). At the catheter tip, mean forces produced by experimental catheter (B) and the conventional catheter were 0.16 N and 0.26 N, respectively (p < 0.05). In the tube puncture test, the frequency at which the conventional catheter punctured the center-shifted site on the tube at an angle of 20° and speed of 50 mm/min was low (40%). In contrast, experimental catheters (L) and (B) were 100% successful at puncturing both the center and center-shifted sites at 20°. Conclusion: Puncture performance was comparable between the lancet-ground and backcut-ground needles except for penetration forces at the catheter tip. The experimental catheters produced lower penetration forces and induced puncture without target displacement at smaller angles compared with the conventional catheter. Therefore, optimization of the needle can prevent vein deformation and movement, which may increase the first-attempt success rate.

Evaluation of the efficiency of the newly developed needle in emergency room: A single-center observational study

“…The bevel angle of the newly developed needles was 20°, and the penetration forces at the needle and catheter tips for the newly developed needles were low. [9] A previous study indicated that a decrease in skin resistance during insertion may reduce pain, and it is thought that the number of pain spots to be stimulated decreases because a low resistance reduces the extent of skin deformation during PIVC insertion. [17] The newly developed needles may be less painful than the existing needles because of their low penetration forces and resistance during PIVC insertion.…”

“…[17] The newly developed needles may be less painful than the existing needles because of their low penetration forces and resistance during PIVC insertion. [9,17] Therefore, differences between the newly developed and existing needles could have been detected if studies had been conducted considering different outcomes, such as pain scoring. Finally, external validity may be low because there were only a few patients with DIVA in our study.…”

“…[5] Another study on newly developed needles using vinyl chloride tubes reported that the use of this needle reduced the failure rate by 60% as an absolute difference compared with the existing needles. [9] Given the 24% failure rate of the rst insertion in humans in a previous study, a 60% reduction as an absolute difference in failure rate was considered invalid. [5] Therefore, considering its clinical importance, we conservatively estimated a 10% reduction as the absolute difference in the failure rate.…”

Effect of a thin-tipped short bevel needle for peripheral intravenous access on the compressive deformation and displacement of the vein: A preclinical study

“…As in the previous study, the authors set the puncture speed at 50 mm/min. 35 Echo gel was applied to the surface of the model. The 40-mm long IJV embedded in the porcine shoulder was punctured in the midline, and deformation and displacement of the vessel during puncture was monitored by US (eZono-4000, Jena, Germany).…”

“…Thus, needles for intravenous catheters need to have the shorter bevel length and the smooth bevel face, and the resistance forces must be measured until the bevel face of these needles including the catheters penetrates the object. Tanabe et al 35 developed a short bevel needle with a very thin tip and evaluated it using a phantom. The thin-tipped short bevel needle was 24-gauge (outer diameter: 0.55 mm) without any spiny projections on the bevel face and achieved successful puncture at smaller angles than the needles of conventional PIVCs, even when the insertion site on the polyvinyl chloride tube phantom was off-center.…”