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  • Title: Intravenous access: a comparison of two methods.
    Author: Duffy BL, Lee JS.
    Journal: Anaesth Intensive Care; 1983 May; 11(2):135-7. PubMed ID: 6869776.
    Abstract:
    The reliability in providing a continued venous route to the circulation is compared between a winged needle (Abbott "Butterfly--23 INT") and a plastic catheter (Jelco Teflon "Catheter Placement Unit", 22 gauge). The catheter remained within the vein in all cases and had a much lower incidence of total obstruction during the study period. Where an intravenous infusion is not in place, a plastic catheter provides a more reliable access route to the circulation than does a winged needle. The reliability of a winged needle in providing continued access to a vein was compared to that of a plastic catheter in 203 young women undergoing induced abortion by suction curettage. Abbott "Butterfly-23 INT" needles were inserted into veins on the back of the hand in 101 patients, and 22 gauge Jelco Teflon "Catheter Placement Units" with attached Braun Luer stoppers for intermittent injection were inserted into a vein of the back of the hand in 102 patients. Anesthesia was standardized, with each patient receiving appropriate doses of fentanyl and thiopentone followed by inhalation of nitrous oxide and oxygen. 5 minutes after the return to the recovery room an attempt was made to inject normal saline 2 ml through the needle or catheter; if successful, a 2nd injection was attempted about 45 minutes later. More Butterfly needles were blocked at the time of the 1st injection, but the difference was not statistically significant. 2 Butterflys but no Jelcos were out of the vein at the 1st attempt. At the 2nd attempt, 39 Butterfly needles and 5 Jelcos were blocked. Only 57 Butterfly but 96 Jelco devices were still patent, a highly significant difference. In light of the findings, it is recommended that winged needles of the Butterfly type should be considered as providing only temporary venous access, while plastic catheters should be inserted where a reliable intravenous route is required. For prolonged catheter patency, an intravenous infusion may be required to delay or prevent intraluminal thrombosis.
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