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A standardised data form was used to record all data collected during the procedure (figure 1). The primary outcome was the 10?cm hatched visualised analogue scale to record pain associated with the procedure (figure 2). A successful outcome was defined by collection of 0.5?mL arterial blood sample confirmed on analysis. A failed attempt was defined as YES1 Dickson Company PrecisionGlide Needle, Belgium). Study outcome Primary outcome The degree of pain experienced by patients during an ABG puncture with different gauge needles measured on a 10?cm visual analogue scale (VAS). Secondary outcome The success rates during an ABG puncture with different gauge needles. Procedural difficulty as rated by the doctor performing the arterial puncture was also measured on a 10?cm VAS. Additional data regarding complications were collected, although no predetermined definitions were incorporated into the study. The categorical variables included site, gender, complications and operator find more experience level. The continuous variables included pain and difficulty PR 171 score. Data analysis Data were analysed using IBM SPSS Statistics for Windows V.21 (IBM Corporation 2012, Armonk, New York, USA). Two-tailed tests with a significant level of 5% were used throughout the analysis including comparing mean pain VAS scores. Fisher's exact test and Pearson's ��2 (as appropriate) were used to compare the distribution of categorical variables between needle groups. Initial sample size calculations suggested the need for 200 patients to achieve statistically meaningful results. Due to patient recruitment difficulty, the study was discontinued after enrolment of 113 patients. Assuming a common SD of 2.7 for the pain scores in the two needle groups, our study had a 73% power to detect a difference of 1.3 or more in pain scores and a 97% power to detect a difference of two or more. A difference of at least 1.3 or more in the pain score has been demonstrated in the literature to be of clinical significance.4 5 Results A total of 126 patients were enrolled in the study with 7 of them withdrawn due to incomplete data (figure 3). Three had no pain scores, two had no difficulty scores, one had neither pain/difficulty scores and one had no patient details. The groups did not differ in age or sex with the average age of the patient being 64.9?years (SD=15.6?years) and 51.