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Pin-Pricks and Pins’ Tricks: A New Method to Reduce Pin-Prick Pain of Intramuscular and Subcutaneous Injections

Romanò, Carlo L. MD; Cecca, Emanuela MD

doi: 10.1213/01.ANE.0000137804.73204.20
Letters to the Editor: Letters & Announcements

Pini Institute; Milano, Italy;

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To the Editor:

More than 12 billion injections are administered each year worldwide. While needle phobia affects at least 10% of the normal population and may lead to avoidance of medical care (1), no method to reduce pin-prick pain is currently available for large-scale application.

We observed that a nonpainful, tactile stimulation with multiple blunt plastic pins pressed onto the skin at the injection site and during the injection procedure is able to reduce the reported pin-prick pain after intramuscular (−63.2%) or subcutaneous injections (−87.7%), compared with placebo.

A total of 212 patients, receiving intramuscular (gluteus region, 22-gauge needle) and subcutaneous (deltoid region, 27-gauge needle) injections, were randomly assigned to two groups of 106 patients each. In the treated group, an oval plastic disk (54 mm × 40 mm) was used, that supports multiple blunt pins (9 pins per cm2) and with a 5-mm hole in the center, through which the injection needle is inserted (Fig. 1). During the injection procedure this plastic device is pressed onto the skin (applied pressure: approximately 50 g/cm2) immediately prior and during the penetration of the injection needle into the skin. The device does not interfere with drug delivery, and there is no contact between the device and the injection needle. In the control group, an oval flat plastic disk, without pins, was used. A significant (P < 0.0001, unpaired Student’s t-test) pain reduction in the treated group compared with placebo was observed after intramuscular (Visual Analog Score: 5.16 ± 1.37 vs 1.90 ± 1.27) and subcutaneous injections (2.61 ± 0.77 vs 0.32 ± 0.51). A transient skin redness in six patients (5.6%) was the only side effect observed in the treated group.

Figure 1

Figure 1

Carlo L. Romanò, MD

Emanuela Cecca, MD

Pini Institute

Milano, Italy

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1. Hamilton JG. Needle phobia: a neglected diagnosis. J Fam Pract 1995 Aug;41:169–75.
© 2004 International Anesthesia Research Society