Does needle size matter? Patient experience of luteinising hormone-releasing hormone analogue injection

Abstract

To determine whether needle size influences a patient's perception of pain, 50 patients requiring hormonal manipulation for prostate cancer were blindfolded and randomised to receive two goserelin ('Zoladex') or two leuprorelin ('Prostap') injections, using 16-or 23-gauge needles, respectively. Median visual analogue scale pain scores for the first injections of goserelin and leuprorelin were below the level of clinical significance and were not statistically different. Mean administration time for goserelin was significantly shorter than for leuprorelin. In conclusion, there was no statistically significant difference in pain experienced on injection of goserelin and leuprorelin when patients were unaware of needle size.

Effectiveness of skin icing in reducing pain associated with goserelin acetate injection

“…The use of a 16-gauge needle for goserelin acetate rather than a 23-gauge needle of leuprorelin acetate may influence their results [1]. On the other hand, Montgomery et al [2] demonstrated that there was no significant difference in pain intensity between goserelin acetate and leuprorelin acetate when patients received them in a blinded manner. It is important to note that the majority of patients who participated in these two studies reported a VAS pain score \13 mm, which may be considered clinically insignificant [3,4].…”

“…A randomized crossover study demonstrated that patients preferred injection of leuprorelin acetate via a smaller needle than goserelin acetate using a larger needle [1]. However, in contrast, another study showed that if injection was performed with the patient blinded, injection pain intensity was not significantly different between leuprorelin acetate administration with a small needle and goserelin acetate administration using a larger needle [2]. Even if injection pain is tolerable, it is important for patients to have minimum injection pain associated with goserelin acetate.…”

Leuprorelin depot injection: patient considerations in the management of prostatic cancer

“…Patients receiving Lupron ® Depot may experience pain at the injection site lasting up to 2 days, large abscesses, and bruising. However, there was no statistically signifi cant difference in pain experienced on injection of goserelin and leuprorelin when patients were unaware of needle size (Montgomery et al 2005).…”

The Influence of Needle Size on Pain Perception in Patients Treated with Botulinum Toxin A Injections for Axillary Hyperhidrosis

“…Indeed, small needle size has been associated with a lower frequency of pain in healthy volunteers (4) and in a lower intensity of pain in patients with multiple sclerosis (5). However, other studies have shown pain intensity to be either only slightly affected (6) or unaffected by needle size (7,8).…”