From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine.
Department of Pediatrics.
Pediatr Emerg Care. 2022 Feb 1;38(2):e811-e815. doi: 10.1097/PEC.0000000000002458.
Distraction can reduce pain and distress associated with painful procedures but has never been studied in children with solid organ transplants. We aimed to determine whether there is a difference in pain and distress associated with venipuncture in pediatric posttransplant patients who receive distraction compared with those who do not.
Randomized controlled trial of children aged 4 to 17 years with solid organ transplants undergoing venipuncture in the outpatient setting. Patients were randomized to receive distraction or no distraction. The primary outcome was the Faces Pain Scale-Revised. Secondary outcomes were the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale. Exploratory outcomes included the number of venipuncture attempts, time to successful venipuncture, and satisfaction of phlebotomists and parents.
Median age of the 40 children enrolled was 11.5 years. Type of transplants included the heart (67.5%), kidney (22.5%), liver (7.5%), and more than 1 organ (2.5%). There was no difference between the Faces Pain Scale-Revised scores in distraction and no distraction groups (1.4; 95% confidence interval, 0.9-1.9; and 1.3, 95% confidence interval, 0.5-2.1, respectively). There was also no difference in the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale scores, number of venipuncture attempts, or time to successful venipuncture. Phlebotomists were more satisfied with the venipuncture when distraction was implemented.
In children with solid organ transplants, there was no difference in pain and distress associated with venipuncture between those who did and did not receive distraction. There was also no difference in other procedure-related outcomes except for greater phlebotomist satisfaction when distraction was implemented.
分散注意力可以减轻与疼痛相关的程序相关的疼痛和痛苦，但从未在实体器官移植的儿童中进行过研究。我们旨在确定与接受分散注意力的儿科移植后患者相比，接受静脉穿刺的儿童的疼痛和痛苦是否存在差异。
对 4 至 17 岁的接受门诊静脉穿刺的实体器官移植儿童进行随机对照试验。将患者随机分为接受分散注意力或不接受分散注意力的组。主要结局是修订后的面部疼痛量表。次要结局为行为困扰观察量表修订版；面部、腿部、活动、哭泣、安慰；和东安大略儿童医院疼痛量表。探索性结局包括静脉穿刺尝试次数、成功静脉穿刺时间以及采血者和父母的满意度。
纳入的 40 名儿童的中位年龄为 11.5 岁。移植类型包括心脏（67.5%）、肾脏（22.5%）、肝脏（7.5%）和超过 1 个器官（2.5%）。分散注意力组和无分散注意力组的面部疼痛量表修订版评分无差异（1.4；95%置信区间，0.9-1.9；和 1.3，95%置信区间，0.5-2.1，分别）。行为困扰观察量表修订版、面部、腿部、活动、哭泣、安慰和东安大略儿童医院疼痛量表评分、静脉穿刺尝试次数或成功静脉穿刺时间也无差异。实施分散注意力时，采血者对静脉穿刺更满意。
在实体器官移植的儿童中，接受或不接受分散注意力的静脉穿刺与疼痛和痛苦之间没有差异。除了实施分散注意力时采血者满意度更高外，其他与程序相关的结局也没有差异。
