Publication:

Efficacy of combination of non-pharmacological methods for pain management in children undergoing venipuncture/IV cannulation/immunisation

Background Any invasive procedure in children will result in anxiety and pain. The use of needles is one of the most traumatic experiences that a child faces in hospital. Distraction is a simple and cost-effective approach for pain management. The aim of the study was to evaluate three non-pharmacological methods, distraction cards, Spinner and videos in terms of pain control during immunization or venipuncture in children.

Method This was a randomized controlled study conducted among 100 children between the age of 7 months and 2 years over a period of 2 months from April 2024 to May 2024 in the department of Paediatrics, MVJ Medical College and Research Hospital, Hoskote, Bangalore. The children undergoing invasive procedures were randomized into four groups: the no distraction group, the Distraction cards group, the Spinner group, and the Videos group. The invasive procedure was done along with the nonpharmacological intervention in the respective groups. Children’s pain was assessed using FLACC (Face, Legs, Activity, Cry, Consolability) pain scale.

Results Severe pain was observed more among the no distraction group and mild pain was observed more among the videos group. The mean FLACC scores of the different groups were 5.48±1.85 (No distraction), 5.12±1.810 (Distraction cards), 4.00±1.871 (Spinner) and 3.32±1.773 (videos).  Significant difference in pain scale was seen with the use of Spinner (p=0.007) and videos (p <0.001) when compared with no distraction. Distraction cards failed to generate a significant reduction in pain as compared to the standard procedure.

Conclusion Non-pharmacological methods of pain control during invasive procedure including videos and Spinner are effective means of pain control. Utilizing non-pharmacological pain management techniques during immunization or venipuncture proves to be an effective and straightforward approach to enhancing children's compliance levels.