Gahlawat Megha, Kodi Malar, Deol Rupinder
Nursing Officer, ESIC Hospital, Delhi, India.
Assistant Professor, College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttrakhand, India.
Sudan J Paediatr. 2021;21(2):162-172. doi: 10.24911/SJP.106-1590387019.
Pain and anxiety are the most common and prevalent adverse stimuli experienced by hospitalised children. The most frightening and distressing source of pain and anxiety accounted for is due to venipuncture. This study aimed to assess the effect of cold and thermomechanical stimulation on pain and anxiety during intravenous (IV) cannulation among children. We conducted a prospective parallel-group randomised control trial in children who required IV cannulation. In the intervention group, external cold and thermomechanical stimulation was applied before 60 seconds, above 5 cm over IV cannulation site through Buzzy device, while the control group received routine care. Children's level of anxiety and pain was assessed using the Children's Fear Scale (CFS) and Wong-Baker Faces pain Scale (WBFS). Mean scores of the self-reported procedural level of pain were less in the intervention group as compared to the control group (2.80 ± 1.86, 7.47 ± 2.40). Median of procedural pain level showed a significant difference between the intervention and control group at < 0.001, inferring that the Buzzy device strongly resulted in a reduction of perception of pain during the cannulation procedure. However, no significant difference was observed in the median of the procedural level of anxiety between the two groups ( = 0.208), stating that cold and thermomechanical stimulation did not affect the level of anxiety of children. Nevertheless, the combination of cold and thermomechanical stimulation through the Buzzy device did not have a significant impact on the procedural level of anxiety among children. Still, it could optimally alleviate the level of pain.
疼痛和焦虑是住院儿童最常见且普遍存在的不良刺激。最令人恐惧和痛苦的疼痛与焦虑来源是静脉穿刺。本研究旨在评估冷刺激和热机械刺激对儿童静脉置管期间疼痛和焦虑的影响。我们对需要静脉置管的儿童进行了一项前瞻性平行组随机对照试验。在干预组中，通过Buzzy设备在静脉置管部位上方5厘米以上、置管前60秒施加外部冷刺激和热机械刺激，而对照组接受常规护理。使用儿童恐惧量表（CFS）和面部表情疼痛量表（WBFS）评估儿童的焦虑和疼痛程度。与对照组相比，干预组自我报告的操作过程疼痛平均得分更低（2.80±1.86，7.47±2.40）。操作过程疼痛程度的中位数在干预组和对照组之间显示出显著差异，P<0.001，这表明Buzzy设备在置管过程中能显著降低疼痛感知。然而，两组之间操作过程焦虑程度的中位数未观察到显著差异（P = 0.208），这表明冷刺激和热机械刺激并未影响儿童的焦虑程度。尽管如此，通过Buzzy设备进行的冷刺激和热机械刺激的联合应用对儿童操作过程中的焦虑程度没有显著影响。不过，它可以最佳地减轻疼痛程度。
