Skin sensitivity of the arm.

Abstract

One hundred and sixty seven operating theatre personnel familiar with the practice of venous cannulation were asked to rank (in increasing order from one to five, corresponding to least to most painful) their opinion of the pain which they considered might accompany venous cannulation of each of five vein sites on the upper limb (dorsum of arm, dorsum of hand, cephalic, ventrum of arm and cubital fossa) which may be selected for this purpose. The skin sensitivity of each of the test sites of each volunteer was then assessed with a test device comprising a Tuohy needle and clamp, which together weighed 75.02 g. Following random application of the device to each of the test sites, the volunteer was asked to rank (in increasing order from one to five, corresponding to least to most painful) the actual pain felt. Analysis of pain expectations showed that there was no significant consensus view as to which site would be most tender. Following application of the test device the tenderness of the five sites was ranked (i) according to frequencies; dorsum of arm < dorsum of hand < cephalic < ventrum of arm < cubital fossa and, (ii) following statistical analysis: dorsum of arm = dorsum of hand = cephalic < ventrum of arm < cubital fossa. There was no correlation between expected and actual skin sensitivities. Knowledge of the different skin sensitivities of the upper limb may be useful when selecting a vein for venepuncture or the insertion of an indwelling venous catheter.