Comparison of music and vapocoolant spray in reducing the pain of venous cannulation in children age 6-12: a randomized clinical trial

Abstract

Background Venous cannulation is among the most stressful and painful experiences of children hospitalization. Children with thalassemia need regular blood transfusion which needs venous access each time. The quality of care and quality of life of children will be improved if appropriate methods are used to reduce pain. This study aimed to compare vapocoolant spray and music in the reduction of pain of Venous cannulation in children with thalassemia. Methods The study was a randomized controlled clinical trial with a cross-over design. Thirty-six children with thalassemia from Thalassemia Patients of Pasteur Hospital in Bam from October to December 2020 and were recruited and randomly allocated to two arms. The pain of venous cannulation (no treatment) was measured in the first blood transfusion session as control. In the second and third sessions, two arms received music and vapocoolant spray before the venous cannulation with a cross-over design. The intensity of pain was measured by a Visual Analogue Scale (VAS). The change in pain scores was tested by ANOVA and Tukey post-hoc test between three measurements. Results During and after the cannulation, the pain was significantly lower in the vapocoolant measurement than in control and music (p < 0.05). There was a significant effect of vapocoolant spray during the procedure F (2, 90) = 25.604, p = 0.001. Also, there was a significant effect of vapocoolant spray after the procedure F (2, 90) = 10.087, p = 0.004). Music did not reduce the pain during cannulation (p = 0.413) and after that (p = 0.807) significantly when compared with control. Conclusions Vapocoolant was an effective method of pain reduction in the reduction of venous cannulation pain. Music was not effective in the reduction of venous cannulation pain when we compared it with controls. The pain of venous cannulation is rated as high and it can have negative effects on the children. There is a need to do more research on the methods of pain reduction of venous cannulation. Trial registration The trial is registered: IRCT20111019007844N13, 13/03/2020. Available at: https://en.irct.ir/trial/42904.

Efficacy and safety of vapocoolant spray for vascular puncture in children and adults: A systematic review and meta-analysis

“…3 studies were published before 2000 (in 1990 [ 32 ] 1995 [ 33 ] and 1999 [ 34 ], 7 studies were published between 2001–2010 [ 35 – 41 ], and the remaining 15 studies were published in 2011 and 2022 [ 31 , 42 – 55 ]. 11 of the included studies originated from USA [ 31 , 34 – 36 , 40 , 43 – 45 , 47 , 49 , 51 ], 3 each from UK [ 32 , 33 , 39 ] and Iran [ 46 , 48 , 55 ], 2 each from Australia [ 37 , 41 ] and Turkey [ 42 , 53 ], and one each from Thailand [ 54 ], Germany [ 50 ], India [ 52 ] and Canadia [ 38 ]. The participants of study in 19 were adults [ 31 – 34 , 37 , 39 – 42 , 44 , 45 , 47 – 54 ], 6 [ 35 , 36 , 38 , 43 , 46 , 55 ] were children.…”

“…11 of the included studies originated from USA [ 31 , 34 – 36 , 40 , 43 – 45 , 47 , 49 , 51 ], 3 each from UK [ 32 , 33 , 39 ] and Iran [ 46 , 48 , 55 ], 2 each from Australia [ 37 , 41 ] and Turkey [ 42 , 53 ], and one each from Thailand [ 54 ], Germany [ 50 ], India [ 52 ] and Canadia [ 38 ]. The participants of study in 19 were adults [ 31 – 34 , 37 , 39 – 42 , 44 , 45 , 47 – 54 ], 6 [ 35 , 36 , 38 , 43 , 46 , 55 ] were children.…”

“…The intervention of all the studies was venipuncture and intravenous cannulation, except for 3 were arterial puncture [ 39 , 48 , 52 ]. Regarding the type of vapocoolant in the experimental groups, ethyl chloride was implemented in 12 studies [ 31 – 37 , 39 , 42 , 44 , 52 , 54 ], fluorohydrocarbon was conducted in 7 studies [ 38 , 40 , 43 , 45 , 47 , 49 , 51 ], 2 studies were alkane mixture [ 41 , 48 ] and 4 were not described [ 46 , 50 , 53 , 55 ]. 25 studies compared vapocoolant to non-anaesthesia, either directly no-treatment [ 32 – 34 , 37 , 39 , 46 , 53 , 55 ] or amongst other arms including placebos [ 31 , 34 , 38 , 41 , 42 , 44 , 45 , 47 – 49 , 51 , 54 ], ice pack [ 43 , 52 ] and isopropyl alcohol [ 35 , 36 , 50 ].…”

“…10 included studies used pain numeric rating scale (NRS), 15 studies used a visual analogue scale (VAS). Furthermore, 21 studies [ 31 – 34 , 36 – 46 , 48 , 50 , 52 – 55 ] reported pain outcome with continuous variables, of which 3 studies [ 35 , 41 , 43 ] expressed outcome by interquartile range and then we applied methods recommended by Luo and Wan to calculate mean and standard deviation. The remaining 4 studies [ 35 , 47 , 49 , 51 ] were presented as dichotomous variables.…”

“…It is noteworthy that only 9 of the included studies were described as double blinded [ 36 , 38 , 41 , 44 , 45 , 47 – 49 , 51 ]. 12 studies revealed the content of the blinding of the participants and personnel [ 31 , 34 , 36 , 38 , 41 , 44 , 45 , 47 – 51 ], and 5 studies mentioned that the blind was not available to patients and personnel [ 40 , 42 , 46 , 52 , 55 ]. 13 studies have described for assessment by evaluators who were unaware of the intervention [ 36 , 38 , 41 , 43 – 45 , 47 – 49 , 51 – 53 , 55 ] and only 2 studies reported the blindness of the assessor [ 40 , 46 ].…”