Biochemical and Pain Comparisons Between the Laser Lancing Device and Needle Lancets for Capillary Blood Sampling: A Randomized Control Trial

Abstract

Background and Objectives: Patients around the world use a lancing device to perform self-monitoring of blood sugar (SMBG). However, there are always fears of needles and pain. Therefore, less painful devices are being developed. The purpose of this study was to compare the usefulness and safety of a laser lancing device (without a needle) to a conventional needle lancet (with a needle) for capillary blood sampling. Study Design/Materials and Methods: A total of 40 healthy subjects were enrolled in the study. Capillary blood was collected from a laser lancing device (without a needle) and a conventional needle lancet (with a needle) on opposite fingers, the choice of which was randomly selected. The laser lancing device (LMT-3000) uses a 2940 nm monopulse laser, a radiation field of 350 μm, laser energy of 210 mJ, and a 3.7 V battery. One week later, capillary blood was obtained by switching the devices and fingers. The biochemical measurements and pain were compared between the two groups. Puncture pain was measured on a pain scale from 0 to 10. Result: All patients were tested with both a laser lancing device and a conventional needle lancet. In the biochemical analysis, the blood glucose level was 103.21 ± 17.20 mg/dl in laser lancing device group and 102.25 ± 22.44 mg/dl in the conventional needle lancet group, and there were no significant differences between the two groups (P = 0.940). The pH, CO 2 , O 2 , lactate and hematocrit levels of the blood were no significant differences between the two groups. In the first trial, the median pain score (interquartile range) of patients using laser lancing device was 2.0 (1.0-3.0), whereas it was 2.5 (2.0-4.0) in patients using a conventional needle lancet (P = 0.029). In the second trial, one week later, the median pain score in the laser lancing device group was 2.5 (1.0-4.0), whereas it was 3.5 (2.25-5.0) in the conventional needle lancet group (P = 0.001). The difference in pain scores between the first and second trials was significant in the conventional needle lancet group (P = 0.007), but not in the laser lancing device group (P = 0.150). Conclusion: There was no difference in biochemical results between the laser lancing device group and the conventional needle lancet group. The laser lancing device demonstrated comparatively lower pain than the conventional needle lancet. Lasers Surg. Med.

Comparison between a laser lancing device and lancet for capillary blood sampling, capillary blood hemoglobin measurement, and blood typing

“…First, it resulted in significantly less pain than sampling using a lancet, consistent with the findings of previous studies. 10,12 The Er:YAG laser energy is strongly absorbed by water due to high absorption of light with a wavelength of 2940 μm and can cause selective ablation at a very limited depth in skin tissue with minimal thermal damage. 13 Pulse duration is an important factor in the generation of thermal effects; [13][14][15] with the generation of pulse energy in less time than 1/10,000 s, LMT-1000 minimized thermal damage.…”

“…Considering the lower depth of penetration, sampling using a laser lancing device would only involve the papillary dermis without involvement of the reticular dermis, which has abundant free nerve fibers. 10 The depth of lancet penetration is associated with puncture pain. 16 Second, needle stick injury during the handling and disposal of lancets was avoided during capillary sampling, which would be helpful at donation sites.…”

“…A laser lancing device has a penetration depth lower than that of a lancet, and this has been postulated to be a cause of less pain. Considering the lower depth of penetration, sampling using a laser lancing device would only involve the papillary dermis without involvement of the reticular dermis, which has abundant free nerve fibers 10 . The depth of lancet penetration is associated with puncture pain 16 .…”

“…Compared with a lancet, a laser lancing device (LMT-3000) was reported to significantly reduce puncture pain without any significant difference in POC test results. 10 However, the effect of laser radiant energy on capillary Hb (cHb) levels and blood typing results has not been fully evaluated. This study aimed (i) to compare the capillary blood Hb levels and blood typing results obtained by laser lancing device with those obtained by a lancet, (ii) to evaluate the use of a laser lancing device for identifying participants with low Hb levels (<12.5 g/dl), (iii) to compare lancing pain between the two lancing devices, and (iv) to examine the feasibility of blood donor screening tests at the donation sites.…”

“…LMT‐1000 is a more compact version of the Food and Drug Administration‐approved LMT‐3000 (LaMeditech, Seoul, Korea), which uses the same laser as LMT‐3000 but is smaller, lighter, and more affordable. Compared with a lancet, a laser lancing device (LMT‐3000) was reported to significantly reduce puncture pain without any significant difference in POC test results 10 . However, the effect of laser radiant energy on capillary Hb (cHb) levels and blood typing results has not been fully evaluated.…”