Bisogni Sofia, Dini Chiara, Olivini Nicole, Ciofi Daniele, Giusti Francesca, Caprilli Simona, Gonzalez Lopez José Rafael, Festini Filippo
Department of Health Sciences, University of Florence, Viale Pieraccini 24, 50139 Florence, Italy.
BMC Res Notes. 2014 Oct 18;7:735. doi: 10.1186/1756-0500-7-735.
Venipuncture pain in children results from a variety of co-factors which increase the intensity of the nociceptive stimulus. Among them, anticipatory anxiety plays an important role. Children with chronic diseases undergo invasive procedures and venipuncture more often than other children. Some healthcare professionals still believe that children who are repeatedly exposed to painful procedures, such as children with chronic diseases, gradually increase their pain tolerance and that, as a result, they have a higher pain threshold than children with no chronic diseases. The purpose of this study was to assess whether a difference exists in the perception of venipuncture pain between children with chronic diseases and children with no previous health problems nor experience of venipuncture.
A cross-sectional study was carried out using the Wong and numeric pain scales and the Observational Scale of Behavioral Distress (OSBD) for the assessment of behavioral distress. A group of children with chronic diseases and a group of children with no previous health problems nor experience of venipuncture, aged 4 to 12 years, both boys and girls, were observed during a standardized venipuncture procedure.
The study included 230 children in total: 82 of them suffered from chronic diseases and had already experienced venipuncture at least once, while the remaining 148 children had no previous experience of venipuncture. The children with chronic diseases reported more pain (median pain score of 8 on the Wong or numeric scales,) and showed more signs of behavioral distress (median score of 27 on the OSBD) than non-chronic children (median pain score of 2 on the Wong/numeric scales, p = 0.00001; median OSBD score 5, p = 0.00001).
Our study suggests that children with chronic diseases have a lower pain threshold than children of the same sex and age who experience venipuncture for the first time.
儿童静脉穿刺疼痛由多种共同因素导致，这些因素会增强伤害性刺激的强度。其中，预期性焦虑起着重要作用。患有慢性病的儿童比其他儿童更常接受侵入性操作和静脉穿刺。一些医护人员仍然认为，反复经历痛苦操作的儿童，如患有慢性病的儿童，会逐渐提高他们的疼痛耐受性，因此他们的疼痛阈值比没有慢性病的儿童更高。本研究的目的是评估患有慢性病的儿童与既无既往健康问题也无静脉穿刺经历的儿童在静脉穿刺疼痛感知上是否存在差异。
采用面部表情疼痛量表和数字疼痛量表以及行为痛苦观察量表（OSBD）进行横断面研究，以评估行为痛苦。在标准化静脉穿刺过程中，观察了一组4至12岁、有慢性病的儿童和一组既无既往健康问题也无静脉穿刺经历的儿童，包括男孩和女孩。
该研究共纳入230名儿童：其中82名患有慢性病且至少经历过一次静脉穿刺，其余148名儿童没有静脉穿刺经历。与非慢性病儿童相比，患有慢性病的儿童报告的疼痛更多（面部表情疼痛量表或数字量表上的疼痛中位数为8分），行为痛苦迹象更明显（行为痛苦观察量表上的中位数为27分）（面部表情/数字量表上的疼痛中位数为2分，p = 0.00001；行为痛苦观察量表中位数为5分，p = 0.00001）。
我们的研究表明，患有慢性病的儿童比首次接受静脉穿刺的同性和同龄儿童疼痛阈值更低。
