An end to needle phobia: Device could make painless injections possible

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study. Credit: © uwimages / Fotolia

Imagine no tears during infant vaccines and no fear of the needle for those old enough to know what's coming. Such painless injections could be possible with a device that applies pressure and vibration while the needle is inserted in the skin, according to a study presented at the ANESTHESIOLOGY™ 2014 annual meeting.

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study and a professor of anesthesiology in perioperative medicine and pain management at the University of Saskatchewan, Saskatoon, Canada. 

"Our early research suggests that using a device that applies pressure and vibration before the needle stick could help significantly decrease painful sensations by closing the 'gate' that sends pain signals to the brain."

Researchers studied the use of pressure, vibration, and cooling or warming in 21 adults poked in the shoulder by a plastic needle that doesn't break the skin but produces needle-like pain. They tested different levels of pressure, vibration and temperature to determine the amount that provided the most benefit. The perception of pain was significantly decreased when a specific amount of pressure and vibration was applied to the site for 20 seconds prior to using the plastic needle. The addition of heat added a small benefit, but it wasn't significant. The study should be repeated in children, who may experience pain differently, said Dr. McKay. The addition of heat or cold might be more beneficial, he said.

While commercial devices that include some of these features are available, they could be improved by incorporating the additional features tested in this and other studies, he said. They could be used to prevent pain prior to providing intravenous (I.V.) treatment, the drawing or donating of blood, or administering vaccinations.

The concept likely works by distraction as well as employing the gate-control theory of pain, in which these sensations (pressure, vibration and potentially temperature) close the gate that allows the brain to register pain.

Source: American Society of Anesthesiologists (ASA)

Technique for cardiovascular diagnostics shows promise

Researcher Elira Maksuti is involved in developing and testing a promising method for diagnosing atherosclerosis, or hardening of the arteries. Credit: Staffan Larsson

A new technique developed at Sweden's KTH Royal Institute of Technology shows promise for early diagnosis and treatment of cardiovascular disease.

Hardening of the arteries, or atherosclerosis, is a common disorder that occurs when fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques. The condition can lead to heart attacks and strokes.

To diagnose atherosclerosis, doctors today rely on ultrasonic grayscale images to visually assess vascular function and how very large arteries move. The less mobility, the more developed the case of atherosclerosis.

But it is an indirect measurement. Better diagnoses can be made when the stiffness of the blood vessels can be analysed, explains Elira Maksuti, a researcher at the Department of Medical Imaging Technology at KTH.

"You need a doctor who is an expert and has extensive experience in order to get a good diagnosis," she says.

But by combining the technologies of shear wave elastography and ultrasound, Maksuti and researcher Erik Widmanh, have developed an inexpensive and non-invasive method not only for checking the stiffness of blood vessels, but for analysing the type of plaque present in the artery.

Maksuit says their method not only offers a potentially more effective way to diagnose atherosclerosis, but the ultrasound technology that it relies on is less expensive -- and safer -- than other imaging alternatives, such as magnetic resonance imaging (MRI) or computed tomography (CT).

The technique was tested on artificial blood vessels, or "phantom" vessels, which allowed the researchers to experiment with not only vascular stiffness, but also pressure and flow.

Maksuti says that with the success of tests on these phantoms, the next step is testing the technique with blood vessels from pigs. "These tests also look very promising," she says.

"We see two major future applications before us," she says. "The first is to determine when a patient's blood vessels are becoming rigid, that is, when the atherosclerosis process begins.

"The second application is to be able to diagnose the type of calcification -- or plaque -- present in the blood vessel." Not all plaque is the same: it ranges from hard to soft. If the plaque is soft and has a thin, hard shell, it is more likely to come loose inside the blood vessel.

It's a difficult distinction to determine. But the information is critical in deciding whether to open the artery surgically. "Today it is rather a matter of guessing. A doctor cannot know," she says. And to complicate matters, such operations can also generate strokes.

Source: KTH The Royal Institute of Technology