A randomised control trial to determine whether “tapping” on a vein improves perceived ease of venous cannulation, and rate of successful cannulation in patients undergoing elective surgery.

Status

Completed

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12613000471785

Enrollment

120

Registered

2013-04-26

Start date

2013-01-18

Completion date

2013-02-05

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Peripheral intravenous cannulation is a commonly performed procedure. The insertion of an intravenous cannula is usually uncomplicated, however it can be difficult in certain patients, including hypovolemic or critically ill patients, IV drug users, patients having repeated courses of chemotherapy, and obese patients. Perceived ease and efficiency of cannulation is related to the experience of the cannulator. It has been shown that, when certain manoeuvres are performed, for example, warming the skin prior to insertion of a peripheral venous cannula, both the time taken for insertion and number of attempts required for cannulation are reduced. A randomised controlled trial evaluated ultrasound guided peripheral venous cannulation in patients with a history of difficult intravenous cannulation, however it found no significant difference between the two groups in time to successful cannulation, number of attempts or number of subjects in whom IV cannulation was successful on the first attempt. It is common practice for health professionals to tap a vein, prior to cannulation, on the assumption that it will improve the perceived ease of cannulation and therefore the likelihood of successful cannulation. This assumption is based on anecdotal evidence and a rigorous investigation of the effect of tapping of the vein on the time taken and the number of attempts required to cannulate has not been undertaken. The optimisation of conditions is important for this commonly performed procedure. Failed attempts at cannulation can lead to fear induced vasoconstriction by activation of the sympathetic nervous system, resulting in subsequent attempts being more difficult. Multiple attempts at cannulation are also unpleasant for the patient. We investigated whether or not tapping of a selected vein prior to cannulation improved the perceived ease of cannulation and the success of cannulation.

Interventions

Peripheral venous cannulation by an experienced anaesthetic registrar prior to admission to theatre/surgery. This will be timed and recorded as successful or unsuccessful by the assistant. The registrar is blinded to the intervention. The assistant lightly taps on the dorsum of the patient's hand, over the previously rated vein (by anaesthetic registrar) for 20 seconds. This occurs only once prior to reassessment of the vein and cannulation by the anaesthetic registrar.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Educational / counselling / training

Masking

Blinded (masking used) (Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Inclusion criteria – All patients admitted to Day of Surgery Admission Unit (DOSA) for same-day elective surgery who require a venous cannula.

Exclusion criteria

Exclusion criteria – Patients will be excluded if they are premedicated, unable to communicate in English, intellectually impaired, age<18 yr or recently ingested analgesic medication

Outcome results