Children's Hospital of Fudan University, No. 399, Wanyuan Rd, Minhang District, Shanghai, China.
BMC Pediatr. 2023 Feb 3;23(1):58. doi: 10.1186/s12887-023-03855-z.
Venipuncture is a routine nursing procedure in the pediatric ward for blood collection and transfusion. However, this procedure can cause severe pain and distress if not adequately managed.
Children aged 3-16 years old were randomized into three groups: EMLA group, distraction group, and combined group. The primary outcome was children's self-reported pain scored using the Wong-Baker FACES® Pain Rating Scale. The parents-reported and observer-reported pain were scored using the Revised Face, Legs, Activity, Cry and Consolability Scale, and children's salivary cortisol levels, heart rate, percutaneous oxygen saturation, venipuncture duration and retaining time of IV cannulas were the secondary outcomes.
A total of 299 children (167 male, 55.8%, median age 8.5) were enrolled: EMLA group (n = 103), distraction group(n = 96) and combined group(n = 100). There was no statistical difference in self-reported pain (P = 0.051), parent-reported pain (P = 0.072), and observer-reported pain (P = 0.906) among the three groups. All three interventions can decrease children's pain during IV cannulations. Additionally, the distraction group's salivary cortisol levels were lower than the combined group(P = 0.013). Furthermore, no significant difference was observed in the heart rate(P = 0.844), percutaneous oxygen saturation (P = 0.438), venipuncture duration (p = 0.440) and retaining time of IV cannulas (p = 0.843) among the three groups.
All three groups responded with slight pain during the peripheral venipuncture procedure. Therefore, medical workers in pediatric settings can use the interventions appropriate for their medical resources and availability while involving parents and children's preferences whenever possible.
This trial was registered on https://register.
gov/ (Gov.ID NCT04275336).
在儿科病房中，静脉穿刺是采集和输血的常规护理程序。然而，如果处理不当，该程序可能会引起严重的疼痛和不适。
将年龄在 3-16 岁的儿童随机分为三组：EMLA 组、分散注意力组和联合组。主要结局是使用 Wong-Baker FACES®疼痛评定量表评估儿童的自我报告疼痛。父母报告和观察者报告的疼痛采用修订后的面部、腿部、活动、哭泣和安慰量表进行评分，儿童的唾液皮质醇水平、心率、经皮血氧饱和度、静脉穿刺持续时间和留置静脉留置针时间为次要结局。
共纳入 299 名儿童（男 167 名，55.8%，中位年龄 8.5 岁）：EMLA 组（n=103）、分散注意力组（n=96）和联合组（n=100）。三组儿童的自我报告疼痛（P=0.051）、父母报告疼痛（P=0.072）和观察者报告疼痛（P=0.906）无统计学差异。所有三种干预措施均可减轻静脉穿刺过程中的儿童疼痛。此外，分散注意力组的唾液皮质醇水平低于联合组（P=0.013）。此外，三组儿童的心率（P=0.844）、经皮血氧饱和度（P=0.438）、静脉穿刺持续时间（p=0.440）和留置静脉留置针时间（p=0.843）无显著差异。
三组儿童在进行外周静脉穿刺时均有轻微疼痛反应。因此，儿科医护人员可以根据医疗资源和可用性选择适当的干预措施，同时尽可能考虑家长和儿童的偏好。
本试验在 https://register.
gov/（Gov.ID NCT04275336）上注册。
