Abstract

The epidural blood patch (EBP) requires a syringe that connects to the intravenous and epidural route. Thereby contravening Department of Health guidance, which recommends adoption of equipment that, prevents wrong route drug administration. To comply with these recommendations a non-Luer butterfly needle with one-way valve has been produced by GBUK. The one-way valve and length of tubing has the potential of activating the clotting cascade. This could reduce the time clinicians have to utilise the blood in the syringe. Also any alteration in clotting could affect the therapeutic value of the EBP. The primary objective of this research was to determine if phlebotomy using this new 21G needle altered blood clotting, determined by thromboelastograph analysis, compared to a standard 21G hypodermic needle.

We performed paired phlebotomy on 10 healthy volunteers; producing a study capable of revealing a 25% change in R-time (power 80%). Mean R-time was increased with the new needle, however remaining within normal range (7.3 vs 6.6 min (p=0.04)). This would not limit the time to utilise the blood before clot formation in the syringe. With no clinically relevant difference in MA or LY30, it is unlikely to have any impact on the therapeutic value of the EBP.