Gupta Devendra, Agarwal Anil, Dhiraaj Sanjay, Tandon Manish, Kumar Mukesh, Singh Ravi Shankar, Singh Prabhat K, Singh Uttam
Department of Anesthesia and Biostatistics, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India.
Anesth Analg. 2006 May;102(5):1372-5. doi: 10.1213/01.ane.0000205741.82299.d6.
Venipuncture is the most common painful event for a hospitalized child. We evaluated the efficacy of balloon inflation for attenuating venipuncture pain in children. Seventy-five pediatric patients aged 6-12 yr, ASA physical status I-II, of either sex, undergoing elective surgery were included in this prospective and randomized study. Patients were randomly divided into 3 equal groups of 25 each; Group I (control), Group II (distraction) pressed a rubber ball, and Group III (balloon) inflated a balloon. A manual venous occlusion was applied on the forearm and venipuncture was performed with a 22-gauge venous cannula. Pain was self-reported by a pain face scale with a 10-cm visual analog scale (VAS) placed at its back, where 0 = "no pain" and 10 = "worst imaginable pain." VAS scores of 1-3 were rated as mild, 4-6 as moderate, and >6 as severe. Median (interquartile range) VAS score in the balloon group was 1 (3), which was reduced as compared with 2 (2) and 4 (2) observed in the distraction and control groups, respectively (P < 0.000). Significant reduction in the incidence and severity of venipuncture pain was also observed in the balloon group compared with the other 2 groups (P < 0.05).
静脉穿刺是住院儿童最常见的疼痛事件。我们评估了球囊充气减轻儿童静脉穿刺疼痛的效果。本前瞻性随机研究纳入了75例年龄在6至12岁、ASA身体状况为I-II级、性别不限、接受择期手术的儿科患者。患者被随机分为3组,每组25例;第一组(对照组),第二组(分散注意力组)按压橡皮球,第三组(球囊组)充气一个气球。在前臂进行手动静脉阻断,并用22号静脉套管进行静脉穿刺。疼痛通过疼痛脸谱量表自我报告,在其背面放置一个10厘米的视觉模拟量表(VAS),其中0 = “无疼痛”,10 = “难以想象的最严重疼痛”。VAS评分为1-3被评为轻度,4-6为中度,>6为重度。球囊组的VAS评分中位数(四分位间距)为1(3),与分散注意力组和对照组分别观察到的2(2)和4(2)相比有所降低(P < 0.000)。与其他两组相比,球囊组静脉穿刺疼痛的发生率和严重程度也显著降低(P < 0.05)。