Comparative efficacy of pharmacological and non-pharmacological interventions for mitigating pain and anxiety associated with venipuncture: a randomised controlled trial

BackgroundVenipuncture is one of the most commonly performed medical procedures in paediatric care, but it can also be one of the most painful and distressing experiences for patients. Finding effective strategies to manage pain and fear associated with venipuncture is crucial for improving the paed...

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Published in:BMJ paediatrics open 2024-09, Vol.8 (1), p.e002881
Main Authors: Suleman, Sherzad Khudeida, Yahya, Nizer, Nilsson, Stefan, Enskär, Karin
Format: Article
Language:English
Subjects:
administration & dosage
adverse effects
Analgesics
Anesthesia
Anesthetics
Anesthetics, Local - administration & dosage
Anesthetics, Local - therapeutic use
Anxiety
Anxiety - etiology
Anxiety - prevention & control
Anxiety - therapy
Behavior modification
Child
Children & youth
drug therapy
Emergency medical care
etiology
Fear & phobias
Female
Health services research
Humans
Intervention
Iraq
Lidocaine
Lidocaine, Prilocaine Drug Combination
Local
Male
methods
Nursing
Omvårdnad
Original Research
Pain
Pain - drug therapy
Pain - etiology
Pain - prevention & control
Pain - psychology
Pain Management
Pain Management - methods
Pain Measurement
Patients
Pediatrics
Performance evaluation
Pharmacology
Phlebotomy
Phlebotomy - adverse effects
prevention & control
Prilocaine Drug Combination
psychology
Research methodology
therapeutic use
therapy
Treatment Outcome
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Yahya, Nizer
Nilsson, Stefan
Enskär, Karin
description BackgroundVenipuncture is one of the most commonly performed medical procedures in paediatric care, but it can also be one of the most painful and distressing experiences for patients. Finding effective strategies to manage pain and fear associated with venipuncture is crucial for improving the paediatric patient experience and promoting positive health outcomes. This study aimed to evaluate the efficacy of a combined approach using a topical analgesic cream (TKTX cream) and a distraction technique (Trace Image and Colouring for Kids-Book, TICK-B) in reducing pain intensity and fear levels in children undergoing venipuncture procedures.MethodsWe conducted this randomised controlled trial among 176 children aged 6–12 years undergoing venipuncture. Participants were randomly assigned to four groups: TICK-B, TKTX cream, TICK-B+TKTX cream and a control group. Pain and fear were measured using the Wong-Baker FACES Pain Rating Scale and Children’s Fear Scale. The study was carried out from 20 February 2024 to 1 June 2024 at the emergency unit of Heevi paediatric teaching hospital in the Kurdistan region of Iraq. In the intervention groups, TICK-B was applied for 2–3 min before needle insertion, and TKTX cream was applied 20 min before the venipuncture procedure. All outcome measures were evaluated 2–3 min after the completion of the venipuncture procedure.ResultsThe combined TICK-B (colouring book) and TKTX cream (topical anaesthetic) intervention was the most effective in reducing both pain intensity (mean score 2.80 vs 7.24 in the control, p
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Finding effective strategies to manage pain and fear associated with venipuncture is crucial for improving the paediatric patient experience and promoting positive health outcomes. This study aimed to evaluate the efficacy of a combined approach using a topical analgesic cream (TKTX cream) and a distraction technique (Trace Image and Colouring for Kids-Book, TICK-B) in reducing pain intensity and fear levels in children undergoing venipuncture procedures.MethodsWe conducted this randomised controlled trial among 176 children aged 6–12 years undergoing venipuncture. Participants were randomly assigned to four groups: TICK-B, TKTX cream, TICK-B+TKTX cream and a control group. Pain and fear were measured using the Wong-Baker FACES Pain Rating Scale and Children’s Fear Scale. The study was carried out from 20 February 2024 to 1 June 2024 at the emergency unit of Heevi paediatric teaching hospital in the Kurdistan region of Iraq. In the intervention groups, TICK-B was applied for 2–3 min before needle insertion, and TKTX cream was applied 20 min before the venipuncture procedure. All outcome measures were evaluated 2–3 min after the completion of the venipuncture procedure.ResultsThe combined TICK-B (colouring book) and TKTX cream (topical anaesthetic) intervention was the most effective in reducing both pain intensity (mean score 2.80 vs 7.24 in the control, p&lt;0.001) and fear levels (mean score 0.93 vs 2.83 in the control, p&lt;0.001) during and after venipuncture procedures compared with individual interventions and control.ConclusionsThe combined TICK-B distraction and TKTX cream topical anaesthetic intervention was the most effective in reducing pain intensity and fear during and after venipuncture in children, providing a practical strategy for healthcare providers to optimise needle procedure management.Trial registration numberNCT06326125.</description><identifier>ISSN: 2399-9772</identifier><identifier>EISSN: 2399-9772</identifier><identifier>DOI: 10.1136/bmjpo-2024-002881</identifier><identifier>PMID: 39251366</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject><![CDATA[administration & dosage ; adverse effects ; Analgesics ; Anesthesia ; Anesthetics ; Anesthetics, Local - administration & dosage ; Anesthetics, Local - therapeutic use ; Anxiety ; Anxiety - etiology ; Anxiety - prevention & control ; Anxiety - therapy ; Behavior modification ; Child ; Children & youth ; drug therapy ; Emergency medical care ; etiology ; Fear & phobias ; Female ; Health services research ; Humans ; Intervention ; Iraq ; Lidocaine ; Lidocaine, Prilocaine Drug Combination ; Local ; Male ; methods ; Nursing ; Omvårdnad ; Original Research ; Pain ; Pain - drug therapy ; Pain - etiology ; Pain - prevention & control ; Pain - psychology ; Pain Management ; Pain Management - methods ; Pain Measurement ; Patients ; Pediatrics ; Performance evaluation ; Pharmacology ; Phlebotomy ; Phlebotomy - adverse effects ; prevention & control ; Prilocaine Drug Combination ; psychology ; Research methodology ; therapeutic use ; therapy ; Treatment Outcome]]></subject><ispartof>BMJ paediatrics open, 2024-09, Vol.8 (1), p.e002881</ispartof><rights>Author(s) (or their employer(s)) 2024. 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Finding effective strategies to manage pain and fear associated with venipuncture is crucial for improving the paediatric patient experience and promoting positive health outcomes. This study aimed to evaluate the efficacy of a combined approach using a topical analgesic cream (TKTX cream) and a distraction technique (Trace Image and Colouring for Kids-Book, TICK-B) in reducing pain intensity and fear levels in children undergoing venipuncture procedures.MethodsWe conducted this randomised controlled trial among 176 children aged 6–12 years undergoing venipuncture. Participants were randomly assigned to four groups: TICK-B, TKTX cream, TICK-B+TKTX cream and a control group. Pain and fear were measured using the Wong-Baker FACES Pain Rating Scale and Children’s Fear Scale. The study was carried out from 20 February 2024 to 1 June 2024 at the emergency unit of Heevi paediatric teaching hospital in the Kurdistan region of Iraq. In the intervention groups, TICK-B was applied for 2–3 min before needle insertion, and TKTX cream was applied 20 min before the venipuncture procedure. All outcome measures were evaluated 2–3 min after the completion of the venipuncture procedure.ResultsThe combined TICK-B (colouring book) and TKTX cream (topical anaesthetic) intervention was the most effective in reducing both pain intensity (mean score 2.80 vs 7.24 in the control, p&lt;0.001) and fear levels (mean score 0.93 vs 2.83 in the control, p&lt;0.001) during and after venipuncture procedures compared with individual interventions and control.ConclusionsThe combined TICK-B distraction and TKTX cream topical anaesthetic intervention was the most effective in reducing pain intensity and fear during and after venipuncture in children, providing a practical strategy for healthcare providers to optimise needle procedure management.Trial registration numberNCT06326125.</description><subject>administration &amp; dosage</subject><subject>adverse effects</subject><subject>Analgesics</subject><subject>Anesthesia</subject><subject>Anesthetics</subject><subject>Anesthetics, Local - administration &amp; dosage</subject><subject>Anesthetics, Local - therapeutic use</subject><subject>Anxiety</subject><subject>Anxiety - etiology</subject><subject>Anxiety - prevention &amp; control</subject><subject>Anxiety - therapy</subject><subject>Behavior modification</subject><subject>Child</subject><subject>Children &amp; youth</subject><subject>drug therapy</subject><subject>Emergency medical care</subject><subject>etiology</subject><subject>Fear &amp; phobias</subject><subject>Female</subject><subject>Health services research</subject><subject>Humans</subject><subject>Intervention</subject><subject>Iraq</subject><subject>Lidocaine</subject><subject>Lidocaine, Prilocaine Drug Combination</subject><subject>Local</subject><subject>Male</subject><subject>methods</subject><subject>Nursing</subject><subject>Omvårdnad</subject><subject>Original Research</subject><subject>Pain</subject><subject>Pain - drug therapy</subject><subject>Pain - etiology</subject><subject>Pain - prevention &amp; control</subject><subject>Pain - psychology</subject><subject>Pain Management</subject><subject>Pain Management - methods</subject><subject>Pain Measurement</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Performance evaluation</subject><subject>Pharmacology</subject><subject>Phlebotomy</subject><subject>Phlebotomy - adverse effects</subject><subject>prevention &amp; 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Finding effective strategies to manage pain and fear associated with venipuncture is crucial for improving the paediatric patient experience and promoting positive health outcomes. This study aimed to evaluate the efficacy of a combined approach using a topical analgesic cream (TKTX cream) and a distraction technique (Trace Image and Colouring for Kids-Book, TICK-B) in reducing pain intensity and fear levels in children undergoing venipuncture procedures.MethodsWe conducted this randomised controlled trial among 176 children aged 6–12 years undergoing venipuncture. Participants were randomly assigned to four groups: TICK-B, TKTX cream, TICK-B+TKTX cream and a control group. Pain and fear were measured using the Wong-Baker FACES Pain Rating Scale and Children’s Fear Scale. The study was carried out from 20 February 2024 to 1 June 2024 at the emergency unit of Heevi paediatric teaching hospital in the Kurdistan region of Iraq. In the intervention groups, TICK-B was applied for 2–3 min before needle insertion, and TKTX cream was applied 20 min before the venipuncture procedure. All outcome measures were evaluated 2–3 min after the completion of the venipuncture procedure.ResultsThe combined TICK-B (colouring book) and TKTX cream (topical anaesthetic) intervention was the most effective in reducing both pain intensity (mean score 2.80 vs 7.24 in the control, p&lt;0.001) and fear levels (mean score 0.93 vs 2.83 in the control, p&lt;0.001) during and after venipuncture procedures compared with individual interventions and control.ConclusionsThe combined TICK-B distraction and TKTX cream topical anaesthetic intervention was the most effective in reducing pain intensity and fear during and after venipuncture in children, providing a practical strategy for healthcare providers to optimise needle procedure management.Trial registration numberNCT06326125.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>39251366</pmid><doi>10.1136/bmjpo-2024-002881</doi><orcidid>https://orcid.org/0000-0001-7308-9761</orcidid><oa>free_for_read</oa></addata></record>
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source BMJ Journals (Open Access); PubMed Central
subjects administration & dosage
adverse effects
Analgesics
Anesthesia
Anesthetics
Anesthetics, Local - administration & dosage
Anesthetics, Local - therapeutic use
Anxiety
Anxiety - etiology
Anxiety - prevention & control
Anxiety - therapy
Behavior modification
Child
Children & youth
drug therapy
Emergency medical care
etiology
Fear & phobias
Female
Health services research
Humans
Intervention
Iraq
Lidocaine
Lidocaine, Prilocaine Drug Combination
Local
Male
methods
Nursing
Omvårdnad
Original Research
Pain
Pain - drug therapy
Pain - etiology
Pain - prevention & control
Pain - psychology
Pain Management
Pain Management - methods
Pain Measurement
Patients
Pediatrics
Performance evaluation
Pharmacology
Phlebotomy
Phlebotomy - adverse effects
prevention & control
Prilocaine Drug Combination
psychology
Research methodology
therapeutic use
therapy
Treatment Outcome
title Comparative efficacy of pharmacological and non-pharmacological interventions for mitigating pain and anxiety associated with venipuncture: a randomised controlled trial
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