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Background: We conducted a nationwide questionnaire-based survey to understand the current situation regarding central venous port implantation in order to identify the ideal procedure., Methods: Questionnaire sheets concerning the number of implantation procedures and the incidence of complications for all procedures completed in 2012 were sent to 397 nationwide designated cancer care hospitals in Japan in June 2013. Venipuncture sites were categorized as chest, neck, upper arm, forearm, and others. Methods were categorized as landmark, cut-down, ultrasound-mark, real-time ultrasound guided, venography, and other groups., Results: We received 374 responses (11,693 procedures) from 153 centers (38.5 %). The overall complication rates were 7.4 % for the chest (598/8,097 cases); 6.8 % for the neck (157/2325); 5.2 % for the upper arm (54/1,033); 7.3 % for the forearm (9/124); and 6.1 % for the other groups (7/114). Compared to the chest group, only the upper arm group showed a significantly lower incidence of complications (P = 0.010), and multivariate logistic regression (odds ratio 0.69; 95 % confidence interval 0.51-0.91; P = 0.008) also showed similar findings. Real-time ultrasound-guided puncture was most commonly used in the upper arm group (83.8 %), followed by the neck (69.8 %), forearm (53.2 %), chest (41.8 %), and other groups (34.2 %)., Conclusion: Upper arm venipuncture with ultrasound guidance seems the most promising technique to prevent complications of central venous port implantation.

The purpose of this study was to determine safe techniques of performing blood collection using an evacuated tube system, particularly with regard to manipulation of the equipment and at the puncture site. Careful observation of the procedure was used to collect data for evaluating the various venepuncture techniques. Nurses were digitally videotaped performing simulated venepuncture. A self-administered questionnaire and unstructured observation of a videotaped recording were evaluated, and valid responses were analyzed from participants who performed venepuncture using various techniques. The participants who changed hands during the procedure were older than those who did not change hands. Needle movements during puncture and insertion, including rotation and insertion in a wave-like trajectory, were observed. Appropriate training, including recommendations for maintaining the stability of the needle tip, is important to ensure safety when performing venepuncture. Movement of the needle should not place too much pressure on the puncture site., (© 2013 Wiley Publishing Asia Pty Ltd.)

Objective: The purpose of this study was to determine the incidence and prognosis of persistent and neuropathic pain induced by venipuncture for blood sampling in clinical practice., Design & Setting: We investigated the incidence of persistent and neuropathic pain after venipuncture for blood sampling and evaluated the prognosis of patients with neuropathic pain at Nihon University Itabashi Hospital, Japan, based on an observational study., Subjects: Outpatients who required venipuncture for blood sampling at the laboratory room of Nihon University Itabashi Hospital between 2004 and 2008 were included as study subjects., Results: In the present study, of the 587,551 venipunctures performed at our hospital between 2004 and 2008, the incidences of persistent and neuropathic pain after venipuncture were 1 in every 4,418 venipunctures (133/587,551) and 1 in every 30,923 venipunctures (19/587,551), respectively. All the 19 patients who were identified as having neuropathic pain recovered completely., Conclusions: We demonstrated that the incidence of persistent pain after venipuncture for blood sampling is low and that its prognosis is good., (Wiley Periodicals, Inc.)