Puangrab Siwatus, Tawanwongsri Weeratian, Mordmuang Auemphon, Khocharoen Wiphada, Krainukun Pimchanok
Department of Anesthesiology, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
Division of Dermatology, Department of Internal Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
Adv Clin Exp Med. 2025 Mar;34(3):343-350. doi: 10.17219/acem/188106.
Venipuncture is one of the most common invasive procedures in healthcare, often resulting in the experience of pain. While audiovisual distraction, topical anesthesia and cold spray application have been reported as methods to reduce pain, there is a lack of studies that focus on comparing their efficacy and safety.
We aimed to compare the efficacy and safety of pain reduction during venipuncture using audiovisual distraction, topical anesthesia and cold spray application.
A randomized controlled study was conducted at Walailak University (Nakhon Si Thammarat, Thailand) from April 2023 to July 2023. Eligible adult participants voluntarily enrolled in the study and were randomly assigned to 1 of 4 groups: group 1 (control), group 2 (topical anesthetic), group 3 (cooling spray), and group 4 (audiovisual distraction). Pain scores and satisfaction levels were assessed following the venipuncture procedure on the upper extremities.
Forty-seven participants were included in the final analysis. The participants had a mean age of 42.3 years (standard deviation (±SD): 13.1), with the majority being female (66.0%). The participants in the intervention groups reported lower pain scores than those in group 1. The mean differences were 2.67 points in group 2 (95% confidence interval (95% CI): 1.49-3.84; p < 0.001), 1.56 points in group 3 (95% CI: 0.15-2.98; p = 0.077), and 1.67 points in group 4 (95% CI: 0.37-2.96; p = 0.042). However, the pain reduction did not reach statistical significance when comparing these 3 interventions. All groups reported a median satisfaction level of 3, with no significant difference among them (H(3) = 6.050, p = 0.109).
Pain reduction interventions, including topical anesthetic, cooling spray and audiovisual distraction, are effective methods for alleviating pain during venipuncture. Participants who received a topical anesthetic reported the lowest pain scores and highest levels of satisfaction.
静脉穿刺是医疗保健中最常见的侵入性操作之一，常常会带来疼痛体验。虽然视听分心、局部麻醉和冷喷雾应用已被报道为减轻疼痛的方法，但缺乏专注于比较它们的疗效和安全性的研究。
我们旨在比较使用视听分心、局部麻醉和冷喷雾应用在静脉穿刺过程中减轻疼痛的疗效和安全性。
2023年4月至2023年7月在瓦莱拉大学（泰国那空是他玛叻）进行了一项随机对照研究。符合条件的成年参与者自愿参加该研究，并被随机分配到4组中的1组：第1组（对照组）、第2组（局部麻醉剂组）、第3组（冷喷雾组）和第4组（视听分心组）。在进行上肢静脉穿刺操作后评估疼痛评分和满意度水平。
47名参与者纳入最终分析。参与者的平均年龄为42.3岁（标准差（±SD）：13.1），大多数为女性（66.0%）。干预组的参与者报告的疼痛评分低于第1组。第2组的平均差异为2.67分（95%置信区间（95%CI）：1.49 - 3.84；p < 0.001），第3组为1.56分（95%CI：= 0.15 - 2.98；p = 0.077），第4组为1.67分（95%CI：0.37 - 2.96；p = 0.042）。然而，比较这3种干预措施时，疼痛减轻未达到统计学显著性。所有组报告的满意度中位数均为3，它们之间无显著差异（H(3)=6.050，p = 0.109）。
减轻疼痛的干预措施，包括局部麻醉、冷喷雾和视听分心，是减轻静脉穿刺过程中疼痛的有效方法。接受局部麻醉的参与者报告的疼痛评分最低，满意度最高。
