One Minute Reading of Usages of Injection Needle

One Minute Reading of Usages of Injection Needle

Injection Needle Usage in treatment of Esophageal Varices

Prepare the syringe with polycinnamic liquid and connect it with injection needle. Choose needle diameter 25G. Exhaust the air, and insert the injection needle through the biopsy channel.

Apply injection around the bleeding point and directly inject on the bleeding point to stop the bleeding. The dosage of a bleeding point is about 5-15 ml, and the maximum dosage shall not exceed 15 ml. When the injection of the liquid comes to the end about 1ml, the assistant should retreat the needle slowly while injection, on the purpose of closing the needle puncture point and preventing bleeding.

Leave the catheter on the puncture point to compress it on the purpose of preventing and reducing bleeding.

Observe the bleeding situation. If necessary, make compression hemostasis or inject sclerosing agent. Pay special attention to the sclerosis dosage. The dosage of sclerosing agent is directly related to the treatment effect. If the dosage is high, complications such as ectopic embolization and ulcer may occur easily.  If the dosage is too low, it cannot have good hemostasis effect.

Injection Needle Usage in treatment ofVarices in Gastric Fundus

Sandwich layer injection method (Iodized Oil, Tissue adhesive compait, Iodized Oil) is most commonly used in treatment of varices in gastric fundus.

Several tips in this operation should be specially mentioned.

Choose 22 G needle to avoid block of liquid in the needle cavity.

Retreat the needle quickly after injecting the final layer of oil to avoid hemostasis.

Hemostasis technique with injection needle

Endoscopic inspection is applied for hemostasis.

Several tips in this operation should be paid with special attention.

Do not use saline as sterile water to wash the bleeding lesion as it could form coagulation and affect the observation. Use 8% norepinephrine.

Choose 23 G needle for upper GI and 25 G needle for lower GI.

Inject 1:10000 adrenalin in 3-4 points around the bleeding lesion, at a distance of 1~2 mm. The total amount of injection shall not exceed 10ml with injection at each point 0.5-1ml.

Adrenalin injection at local position could contract the tiny vessel and lower the blood flow speed. Please pay attention not to injection repeatedly and control strictly the drug dosage.

Make necessary monitoring of the patients such as blood pressure and heart rate.

Under Mucosa Injection in ESD or EMR

During ESD or EMR operations, under mucosa injection is performed to lift the mucosa and prevent bleeding and perforation. Normally 20ml syringe is connected with injection needle.Choose 23G needle for upper GI.

The most commonly used liquid in injection is 100ml saline with adrenalin 1ml and indigo carmine 3-5ml.

Repeated injection may be required during the operation to assure and keep satisfied lifting effect.

To avoid injury to the endoscopic channel, pay attention to retreat the needle point into the catheter after injection and remove the device carefully.