Subcutaneous versus intracutaneous injections of sterile water for labour analgesia: a comparison of perceived pain during administration

Authors

  • Lena Mårtensson,

    Registered Nurse Midwife, Corresponding author
    1. Department of Health Sciences, University of Skövde
      Correspondence: Ms L. Mårtensson, Department of Health Sciences, University of Skövde, Sweden, Box 408, SE-541 28 Skövde, Sweden.
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  • Karin Nyberg,

    Registered Nurse Midwife
    1. Department of Health Sciences, University of Göteborg
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  • Gunnar Wallin

    Consultant
    1. Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Sweden
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Correspondence: Ms L. Mårtensson, Department of Health Sciences, University of Skövde, Sweden, Box 408, SE-541 28 Skövde, Sweden.

Abstract

Objective To investigate whether, during injections of sterile water, there is any difference in perceived pain between intracutaneous and subcutaneous injections.

Design Blind controlled trial with cross-over design.

Setting Göteborg and Skövde, Sweden.

Participants One hundred healthy female volunteers.

Methods The women were randomised into two groups and subjected to two trials, within one week of each other. During the first trial one group (n= 50) received the intracutaneous injection first, followed by the subcutaneous injection. The second group (n= 50) was given the subcutaneous injection first, followed by intracutaneous injection. In both groups all the injections were given in reverse order during the second trial.

Main outcome measures Experienced pain during the administration of sterile water injections, measured by visual analogue scale.

Results The analysis showed intracutaneous injections to be significantly more painful than subcutaneous injections, even after adjusting for injection day and for left/right site of injection (mean 60.8 vs 41.3, P < 0.001).

Conclusions The findings suggest that the less painful subcutaneous injection technique should be used.

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