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Minerva Pediatrica 2016 Dec 22

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

The efficacy of nasal tip hold-press on venous cannulation pain in children: a prospective randomize controlled study

Behzad MAGHSOUDI 1, Mehrdad JOOKAR 2, Hosein HADDAD 3, Zahra ZOONOBI 4, Mahnaz RAKHSHAN 5

1 Anesthesia Department, Fellowship of Cardiac Anesthesia, Fellowship of Critical Care Medicine, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; 2 Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; 3 Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 4 Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran; 5 Community Based Psychiatric Research Center, School of Nursing & Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran


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BACKGROUND: Venipuncture is a common and quiet unpleasant experience for pediatric patients. The pain associated with venous cannulation disturbs the children. Different methods have been used to minimize the pain. The present study evaluated the efficacy of holding and pressing the tip of the nose on the venipuncture pain in pediatric patients.
METHODS: A prospective randomize controlled study carried out using the Visual analogue scale (YAS) for assessment cannulation pain and the Yale preoperative anxiety scale (YPAS) for the assessment of anxiety before cannulation. 60 patients, 6-12 years old, who needed venipuncture for general anesthesia were divided in to two groups of 30 each: the control and the study group. Nasal tip was held and pressed during venipuncture by the parents in the study group. No intervention was done in the control group.
RESULTS: The anxiety scale (YPAS) was not different between the two groups before venous cannulation (P = 0.136). Comparing the two groups. There was no different regarding the change in HR and BP during venous cannulation. There was significantly lower cannulation pain in the study in comparison with the control group (P value = 0.010).
CONCLUSIONS: Holding and pressing the tip of the nose during venipuncture reduce the severity of venipuncture pain in pediatric patients. This could be secondary to distraction along with the physiological effect of the valsalva maneuver on pain. Therefore, we recommend that holding and pressing the tip of the nose is a safe and effective method for reducing the severity of pain from venipuncture in pediatric patients.


KEY WORDS: Nasal tip hold-press - Venous cannulation - Pain - Child

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