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Videogame playing as distraction technique in course of venipuncture
1Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, University of Trieste, Italy. martaminute@gmail.com
Insights
Adding a videogame distraction to EMLA did not significantly reduce needle-related pain in children. While not improving pain relief, this active distraction strategy was well-received and easy to implement.
Area of Science:
- Pediatric Pain Management
- Anesthesiology
- Child Psychology
Background:
- Needle-related procedures are a primary source of pain and distress in children.
- Minimizing needle-related pain is crucial for children requiring frequent hospital admissions.
- EMLA (eutectic mixture of local anesthetics) is commonly used for procedural analgesia.
Purpose of the Study:
- To evaluate the efficacy of active distraction (videogame) combined with EMLA for reducing needle-related pain in children.
- To compare pain perception and procedural outcomes between conventional care and active distraction groups.
Main Methods:
- An open randomized controlled trial involving 97 children aged 4-10 years.
- Two groups: Conventional Care (EMLA only) and Active Distraction (EMLA plus videogame).
- Outcome measures included self-reported pain (FPS-R), observer-reported pain (FLACC), and number of attempts for successful venipuncture/cannulation.
Main Results:
- No significant difference in self-reported pain (FPS-R median 0) between groups.
- Observer-reported pain (FLACC median 1) showed no statistically significant difference, though the active distraction group had a lower percentage of children with major pain (9% vs 18%).
- The median number of attempts for successful procedures was 1 in both groups.
Conclusions:
- Active distraction with videogames does not enhance EMLA analgesia for venipuncture and IV cannulation.
- The strategy is easily applicable and appreciated by children.
- Further investigation of active distraction in other painful pediatric procedures is warranted.
Background:
Needle-related procedures (venipuncture, intravenous cannulation) are the most common source of pain and distress for children. Reducing needle related pain and anxiety could be important in order to prevent further distress, especially for children needing multiple hospital admissions. The aim of the present open randomized controlled trial was to investigate the efficacy of adding an active distraction strategy (videogame) to EMLA premedication in needle-related pain in children.
Methods:
One-hundred and nine children (4 -10 years of age) were prospectively recruited to enter in the study. Ninety-seven were randomized in two groups: CC group (conventional care: EMLA only) as control group and AD group (active distraction: EMLA plus videogame) as intervention group. Outcome measures were: self-reported pain by mean of FPS-R scale (main study outcome), observer-reported pain by FLACC scale, number of attempts for successful procedure.
Results:
In both groups FPS-R median rate was 0 (interquartile range: 0-2), with significant pain (FPS-R > 4) reported by 9% of subjects. FLACC median rate was 1 in both groups (interquartile range 0-3 in CC group; 0-2 in AD group). The percentage of children with major pain (FLACC > 4) was 18% in CC group and 9% in AD group (p = 0.2). The median of necessary attempts to succeed in the procedures was 1 (interquartile range 1-2) in both groups..
Conclusion:
Active distraction doesn't improve EMLA analgesia for iv cannulation and venipuncture. Even though, it resulted in an easily applicable strategy appreciated by children. This technique could be usefully investigated in other painful procedures.
