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三种不同非药物方法对急诊外周静脉置管中置管成功率的影响:一项随机对照试验。

The effect of three different nonpharmacological methods on cannulation success during peripheral intravenous catheter placement in the emergency unit: a randomized controlled trial.

机构信息

General Surgery Clinic, İstanbul Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, 34865, Turkey.

Department of Nursing, Faculty of Health Sciences, Bursa Uludağ University, Bursa, 16059, Turkey.

出版信息

BMC Anesthesiol. 2024 Oct 9;24(1):362. doi: 10.1186/s12871-024-02723-2.

DOI:10.1186/s12871-024-02723-2
PMID:39385099
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11462676/
Abstract

BACKGROUND

Peripheral intravenous catheterization is frequently performed in emergency units, but it is a procedure which is difficult for healthcare professionals and painful for patients. The primary objective of the present study was to examine the effect on venous dilation, procedure duration and pain severity of local heat, cold and vibration applications performed on the intervention area before peripheral intravenous catheterization in adults. The second objective of the study was to examine the effects of age and gender variables on the participants' pain intensity levels.

METHODS

A single-blinded randomized controlled trial. The study included 120 adults who were randomly selected between March and August 2023. One application group (n = 30) received local heat application, one group (n = 30) received local cold application, and one (n = 30) received local vibration using the Buzzy device. The applications, to the site of the peripheral intravenous catheterization, lasted one minute. The control group (n = 30) received standard peripheral intravenous catheterization application. The groups' vein dilation was assessed with the vein assessment scale, pain felt during catheterization with the visual analog scale, and the duration of the procedure with a chronometer.

RESULTS

It was found that the venous dilation of the cold application group was significantly higher (p = 0.010, p = 0.015 respectively) and procedure duration was shorter (p = 0.013, p < 0.001 respectively) than that of the heat and vibration application groups, and its pain severity was significantly lower (p = 0.002, p = 0.001 and p = 0.001 respectively) than that of the control group and the heat and vibration application groups.

CONCLUSIONS

It was determined that local cold application for one minute to the area of peripheral intravenous catheterization increased venous dilation, shortened application time, and reduced pain.

TRIAL REGISTRATION

ClinicalTrials.gov ID NCT06378424, retrospectively registered 20/04/2024.

摘要

背景

外周静脉置管术在急诊室经常进行,但对于医护人员来说是一项具有挑战性的操作,对患者来说也很痛苦。本研究的主要目的是观察在成人外周静脉置管前对干预区域进行局部热、冷和振动应用对静脉扩张、操作时间和疼痛严重程度的影响。研究的第二个目的是观察年龄和性别变量对参与者疼痛强度水平的影响。

方法

这是一项单盲随机对照试验。该研究纳入了 2023 年 3 月至 8 月期间随机选择的 120 名成年人。一个应用组(n=30)接受局部热应用,一个组(n=30)接受局部冷应用,一个组(n=30)使用 Buzzy 装置接受局部振动应用。应用持续一分钟。对照组(n=30)接受标准外周静脉置管应用。使用静脉评估量表评估各组静脉扩张程度,使用视觉模拟量表评估导管插入过程中的疼痛程度,使用计时器评估操作时间。

结果

结果发现,冷应用组的静脉扩张明显更高(p=0.010,p=0.015),操作时间更短(p=0.013,p<0.001),疼痛程度明显更低(p=0.002,p=0.001 和 p=0.001),与对照组和热、振动应用组相比。

结论

结果表明,对周围静脉置管区域进行一分钟的局部冷应用可增加静脉扩张,缩短应用时间,并减轻疼痛。

试验注册

ClinicalTrials.gov ID NCT06378424,于 2024 年 4 月 20 日回顾性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/39bc2d769375/12871_2024_2723_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/fbbbd3284691/12871_2024_2723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/1aed0babddba/12871_2024_2723_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/34fcc3e4808b/12871_2024_2723_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/12258cff12b6/12871_2024_2723_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/39bc2d769375/12871_2024_2723_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/fbbbd3284691/12871_2024_2723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/1aed0babddba/12871_2024_2723_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/34fcc3e4808b/12871_2024_2723_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/12258cff12b6/12871_2024_2723_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92e8/11462676/39bc2d769375/12871_2024_2723_Fig5_HTML.jpg

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J Perianesth Nurs. 2024 Aug;39(4):630-637. doi: 10.1016/j.jopan.2023.11.006. Epub 2024 Feb 29.
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The Impact of Cold Spray and Ice Application During Intravenous Access on Pain and Fear in Children Aged 7-15 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial.儿科急诊室中冷喷和冰敷对7至15岁儿童静脉穿刺时疼痛和恐惧的影响:一项随机对照试验
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Venous dilation effect of hot towel (moist and dry heat) versus hot pack for peripheral intravenous catheterization: a quasi-experimental study.
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