Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220004
Brazilian Journal of Pain
Review Article

Non-pharmacological interventions in painful needle procedures in children: integrative review

Intervenções não farmacológicas em procedimentos dolorosos com agulha em crianças: revisão integrativa

Bárbara Vitória Mendes; Maryana da Silva Furlan; Mariana Bucci Sanches

Downloads: 0
Views: 328

Abstract

BACKGROUND AND OBJECTIVES: The World Health Organization recommends that pain in children should be treated as a fundamental human right. Children in health services are exposed to numerous painful procedures as part of their treatment, for instance, immunization and blood testing. Painful experiences during such procedures can cause extreme anxiety in future conducts, making children more vulnerable to pain. The present study’s objective was to examine the non-pharmacological interventions most described in the literature for pain management during painful procedures with needles in children above the age of one.

CONTENTS: Integrative literature review from CINAHL, Embase, Scopus, Web of Science and Pubmed databases. The publications researched were from between 2010 and 2020. The leading question was “Which are the non-pharmacological interventions most described in the literature for pain control in children undergoing needle procedures”? The database search found 252 articles, six were included in the review and distraction was the most observed strategy for non-pharmacological intervention.

CONCLUSION: The results of this study indicate that the most used strategy for pain relief was distraction, in special the audiovisual distraction.

Keywords

Child, Pain management, Pain procedural

Resumo

JUSTIFICATIVA E OBJETIVOS: A Organização Mundial da Saúde preconiza que a dor na criança seja tratada como um direito humano fundamental. Crianças em serviços de saúde são expostas a diversos procedimentos dolorosos como parte do seu tratamento, a exemplo de imunizações e exames de sangues. Experiências dolorosas durante estes procedimentos podem causar consequências negativas como ansiedade extrema em procedimentos futuros, tornando a criança mais vulnerável à dor. Este estudo teve como objetivo investigar quais são as intervenções não farmacológicas mais descritas na literatura para o controle da dor em procedimentos dolorosos com agulha em crianças acima de um ano.

CONTEÚDO: Trata-se de uma revisão integrativa, utilizando as bases de dados CINAHL, Embase, Scopus, Web of Science e Pubmed. O recorte das publicações foi entre 2010 e 2020. A questão norteadora foi “Quais são as intervenções não farmacológicas mais descritas na literatura para o controle da dor em crianças sob procedimentos com agulha”? Foram encontrados 252 artigos, incluídos seis artigos para análise e a distração foi a estratégia mais observada para intervenção não farmacológica.

CONCLUSÃO: Os resultados deste estudo indicam que a estratégia mais utilizada para o alívio da dor foi a distração, sobressaindo a distração audiovisual.

Palavras-chave

Criança, Dor processual, Manejo da dor

References

Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82.

DeSantana JM, Perissinotti DMN, Junior JOO, Correia LMF, Oliveira CM, Fonseca PRB. Definição de dor revisada após quatro décadas. BrJP. 2020;3(3):197-8.

Koller D, Goldman RD. Distraction techniques for children undergoing procedures: a critical review of pediatric research. J Pediatr Nurs. 2012;27(6):652-81.

Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses. 2012:4.

Young KD. Pediatric procedural pain. Ann Emerg Med. 2005;45(2):160-71.

Resolução nº41 de 13 out 1995. 1995.

The Assessment and Management of Acute Pain in Infants, Children, and Adolescents. Pediatrics. 2001;108(3):793-7.

Birnie KA, Chambers CT, Fernandez CV, Forgeron PA, Latimer MA, McGrath PJ. Hospitalized children continue to report undertreated and preventable pain. Pain Res Manag. 2014;19(4):198-204.

Stevens BJ, Abbott LK, Yamada J, Harrison D, Stinson J, Taddio A. Epidemiology and management of painful procedures in children in Canadian hospitals. CMAJ. 2011;183(7):E403-10.

Fradet C, McGrath PJ, Kay J, Adams S, Luke B. A prospective survey of reactions to blood tests by children and adolescents. Pain. 1990;40(1):53-60.

Goodenough B, Thomas W, Champion GD, Perrott D, Taplin JE, von Baeyer CL. Unravelling age effects and sex differences in needle pain: ratings of sensory intensity and unpleasantness of venipuncture pain by children and their parents. Pain. 1999;80(1-2):179-90.

Humphrey GB, Boon CM, van Linden van den Heuvell GF, van de Wiel HB. The occurrence of high levels of acute behavioral distress in children and adolescents undergoing routine venipunctures. Pediatrics. 1992;90(1 pt 1):87-91.

Van Cleve L, Johnson L, Pothier P. Pain responses of hospitalized infants and children to venipuncture and intravenous cannulation. J Pediatr Nurs. 1996;11(3):161-8.

Taddio A, McMurtry CM, Shah V, Riddell RP, Chambers CT, Noel M. Reducing pain during vaccine injections: clinical practice guideline. CMAJ. 2015;187(13):975-82.

Taddio A, Katz J. The effects of early pain experience in neonates on pain responses in infancy and childhood. Paediatr Drugs. 2005;7(4):245-57.

Anand KJ, Barton BA, McIntosh N, Lagercrantz H, Pelausa E, Young TE. Analgesia and sedation in preterm neonates who require ventilatory support: Results from the NOPAIN trial. Arch Pediatr Adolesc Med. 1999;153(4):331-8.

Hamilton JG. Needle phobia: a neglected diagnosis. J Fam Pract. 1995;41(2):169-75.

Pate JT, Blount RL, Cohen LL, Smith AJ. Childhood medical experience and temperament as predictors of adult functioning in medical situations. Child Health Care. 1996;25(4):281-98.

Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Revisão integrativa: conceitos e métodos utilizados na enfermagem. Rev Esc Enferm USP. 2014;48(2):335-45.

Mendes KDS, Silveira RCCS, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008;17(4):758-64.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

Melnyk Bernadette Mazurek, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: a guide to best practice. 2013;19.

Oliveira NC, Santos JL, Linhares MB. Audiovisual distraction for pain relief in paediatric inpatients: a crossover study. Eur J Pain. 2017;21(1):178-87.

Gupta HV, Gupta VV, Kaur A, Singla R, Chitkara N, Bajaj KV. Comparison between the analgesic effect of two techniques on the level of pain perception during venipuncture in children up to 7 years of age: A quasi-experimental study. J Clin Diagnostic Res. 2014;8(8):1-5.

Gedam DS, Verma M, Patil U, Gedam S. Effect of distraction technique during immunization to reduce behaviour response score (FLACC) to pain in Toddlers. J Nepal Paediatr Soc. 2013;33(1):25-30.

Yildizeli Topcu S, Akgun Kostak M, Semerci R, Guray O. Effect of gum chewing on pain and anxiety in turkish children during intravenous cannulation: a randomized controlled study. J Pediatr Nurs. 2020;52:e26-32.

Bergomi P, Scudeller L, Pintaldi S, Dal Molin A. Efficacy of non-pharmacological methods of pain management in children undergoing venipuncture in a pediatric outpatient clinic: a randomized controlled trial of audiovisual distraction and external cold and vibration. J Pediatr Nurs. 2018;42:e66-72.

Momenabadi A, Radmehr M, Sadeghi N. Effect of two methods of acupressure in Hugo Point and music on severity of pain during IV insertion in children. Pakistan J Med Heal Sci. 2020;14(2):697-700.

Hasanpour M, Tootoonchi M, Aein F, Yadegarfar G. The effects of two non-pharmacologic pain management methods for intramuscular injection pain in children. Acute Pain. 2006;8(1):7-12.

Gold JI, Kim SH, Kant AJ, Joseph MH, Rizzo A. Effectiveness of virtual reality for pediatric pain distraction during IV placement. Cyberpsychology Behav. 2006;9(2):207-12.

Gershon J, Zimand E, Pickering M, Rothbaum Bo, Hodges L. A pilot and feasibility study of virtual reality as a distraction for children with cancer. J Am Acad Child Adolesc Psychiatry. 2004;43(10):1243-9.

Short S, Pace G, Birnbaum C. Nonpharmacologic techniques to assist in pediatric pain management. Clin Pediatr Emerg Med. 2017;18(4):256-60.

Blount RL, Piira T, Cohen LL. Management of Pediatric Pain and Distress Due to Medical Procedures. Handbook of pediatric psychology. 2003:216-33.

McGrath PA. Intervention and management. Children in pain: clinical and research issues from a developmental perspective. 1991:83-115.

Inan G, Inal S. The impact of 3 different distraction techniques on the pain and anxiety levels of children during venipuncture: a clinical trial. Clin J Pain. 2019;35(2):140-7.

Birnie KA, Noel M, Chambers CT, Uman LS, Parker JA. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev. 2018:CD005179.

Gates M, Hartling L, Shulhan-Kilroy J, MacGregor T, Guitard S, Wingert A. Digital technology distraction for acute pain in children: a meta-analysis. Pediatrics. 2020;145(2):e20191139.

Bukola IM, Paula D. The effectiveness of distraction as procedural pain management technique in pediatric oncology patients: a meta-analysis and systematic review. J Pain Symptom Manage. 2017;54(4):589-600.e1.

Newell A, Keane J, McGuire BE, Heary C, McDarby V, Dudley B. Interactive versus passive distraction and parent psychoeducation as pain management techniques during pediatric venepuncture: a randomized controlled trial. Clin J Pain. 2018;34(11):1008-16.

Noel M, Chambers CT, McGrath PJ, Klein RM, Stewart SH. The influence of children’s pain memories on subsequent pain experience. Pain. 2012;153(8):1563-72.

Cerne D, Sannino L, Petean M. A randomised controlled trial examining the effectiveness of cartoons as a distraction technique. Nurs Child Young People. 2015;27(3):28-33.

Susam V, Friedel M, Basile P, Ferri P, Bonetti L. Efficacy of the Buzzy System for pain relief during venipuncture in children: a randomized controlled trial. Acta Biomed. 2018;89(6-S):6-16.

Lescop K, Joret I, Delbos P, Briend-Godet V, Blanchi S, Brechet C. The effectiveness of the Buzzy® device to reduce or prevent pain in children undergoing needle-related procedures: the results from a prospective, open-label, randomised, non-inferiority study. Int J Nurs Stud. 2021;113:103803.

Semerci R, Kocaaslan EN, Akgün Kostak M, Akın N. Reduction of pain during intravenous cannulation in children: Buzzy application. Agri. 2020;32(4):177-85.

Yılmaz D, Özyazıcıoğlu N, Çıtak Tunç G, Aydın Aİ, Atak M, Duygulu Ş. Efficacy of Buzzy® on pain and anxiety during catheterization in children. Pediatr Int. 2020;62(9):1094-100.

Khosravan S, Atayee P, Mazloum Shahri SB, Mojtabavi SJ. Effect of Hugo’s point massage with and without ice on vaccination-related pain in infants. J Hayat. 2018;24(1):7-19.

Aydin D, Sahiner NC. Effects of music therapy and distraction cards on pain relief during phlebotomy in children. Appl Nurs Res. 2017;33:164-8.

Chan E, Hovenden M, Ramage E, Ling N, Pham JH, Rahim A. Virtual reality for pediatric needle procedural pain: two randomized clinical trials. J Pediatr. 2019;209:160-167.e4.

Özalp Gerçeker G, Ayar D, Özdemir EZ, Bektaş M. Effects of virtual reality on pain, fear and anxiety during blood draw in children aged 5-12 years old: a randomised controlled study. J Clin Nurs. 2020;29(7-8):1151-61.

Crevatin F, Cozzi G, Braido E, Bertossa G, Rizzitelli P, Lionetti D. Hand-held computers can help to distract children undergoing painful venipuncture procedures. Acta Paediatr Int J Paediatr. 2016;105(8):930-4.

Walther-Larsen S, Petersen T, Friis SM, Aagaard G, Drivenes B, Opstrup P. Immersive virtual reality for pediatric procedural pain: a randomized clinical trial. Hosp Pediatr. 2019;9(7):501-7.

Lewkowski MD, Barr RG, Sherrard A, Lessard J, Harris AR, Young SN. Effects of chewing gum on responses to routine painful procedures in children. Physiol Behav. 2003;79(2):257-65.

Thrane SE, Wanless l, Thrane SE, Wanless S, Cohen SM. DCTA and N-PT of PPFI to SAT a DLAS of EWRJPN [Internet]. 2016;31(1):e23-32.

Short S, Pace G, Birnbaum C. Nonpharmacologic techniques to assist in pediatric pain management. Clin Pediatr Emerg Med. 2017;18(4):256-60.

Crellin DJ, Harrison D, Santamaria N, Babl FE. Systematic review of the face, legs, activity, cry and consolability scale for assessing pain in infants and children: is it reliable, valid, and feasible for use?. Pain. 2015;156(11):2132-51.

Mehack R, Torgerson WS. On the language of pain. Anesthesiology: J Am Soc Anesthesiol. 1971;34(1):50-9.

Guerreiro M, Curado M. PICAR ... FAZ DOER! Representações de dor na criança, em idade escolar, submetida a punção venosa. Enferm Glob Rev Electrónica Trimest Enferm. 2012;25:75-91.

Kristensen HN, Lundbye-Christensen S, Haslund-Thomsen H, Graven-Nielsen T, Elgaard Sørensen E. Acute procedural pain in children: intervention with the hospital clown. Clin J Pain. 2018;34(11):1032-8.

Lilik Lestari MP, Wanda D, Hayati H. The effectiveness of distraction (Cartoon-Patterned Clothes and Bubble-Blowing) on pain and anxiety in preschool children during venipuncture in the emergency department. Compr Child Adolesc Nurs. 2017;40(1):22-8.

Yilmaz G, Alemdar DK. Using Buzzy, Shotblocker, and Bubble Blowing in a pediatric emergency department to reduce the pain and fear caused by intramuscular injection: a randomized controlled trial. J Emerg Nurs. 2019;45(5):502-11.

Risaw L, Narang K, Thakur JS, Ghai S, Kaur S, Bharti B. Efficacy of flippits to reduce pain in children during venipuncture - a randomized controlled trial. Indian J Pediatr. 2017;84(8):597-600.

Vagnoli L, Caprilli S, Vernucci C, Zagni S, Mugnai F, Messeri A. Can presence of a dog reduce pain and distress in children during venipuncture?. Pain Manag Nurs. 2015;16(2):89-95.


Submitted date:
01/20/2021

Accepted date:
01/06/2022

6285a1a4a953956c78331ac3 brjp Articles

BrJP

Share this page
Page Sections