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Using Vibrating and Cold Device for Pain Relieves in Children: A Systematic Review and Meta-analysis of Randomized
Hui-Chuan Su1, Chia-Wen Hsieh1, Nai Ming Lai2
1Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taiwan.
Insights
Cold-vibration devices significantly reduce pain and anxiety in children during needle procedures. This non-invasive method is safe and more effective in older children, offering a promising clinical solution.
Area of Science:
- Pediatric Pain Management
- Medical Device Technology
- Evidence Synthesis
Background:
- Needle-based procedures are a primary source of pain and distress in children.
- Existing evidence on pain management using cooling and vibrating devices is fragmented.
- A comprehensive synthesis is needed to evaluate the overall efficacy of these interventions.
Purpose of the Study:
- To systematically evaluate the effectiveness of cold-vibration devices for pain and anxiety reduction in children undergoing needle procedures.
- To synthesize evidence from multiple clinical trials on this intervention.
- To explore the influence of patient age on treatment outcomes.
Main Methods:
- A comprehensive literature search was performed across major databases (Cochrane, PubMed, EMBASE, PsycINFO, CINAHL, Airiti).
- Pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) were calculated using RevMan 5.3.
- Meta-regression analysis was employed to assess the relationship between age and pain reduction.
Main Results:
- Sixteen publications involving 1479 children were included in the meta-analysis.
- Cold-vibration devices significantly decreased pain levels in children over 2 years old (MD -3.03, 95% CI: -3.38, -2.68).
- Parental anxiety levels were also reduced (MD -1.3, 95% CI: -1.9, -0.7), with no adverse events reported. Meta-regression showed pain reduction increased with age.
Conclusions:
- Cold-vibration devices are effective in reducing pain and anxiety in children during needle procedures.
- The intervention demonstrates greater efficacy in older children and is associated with no adverse effects.
- The non-invasive nature and ease of use make this device a promising tool for clinical settings.
Objective:
Needle procedures are the most common source of pain, anxiety, and fear among children. A combination of a cooling ice-pack and/or a vibrating motor for pain management in children has been evaluated in trials, but their overall effects await a synthesis of the available evidence.
Method:
Comprehensive search was conducted using Cochrane, PubMed, EMBASE, PsycINFO, CINAHL and Airiti. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3. A meta-regression was conducted to investigate the effects of mean age on MD of pain.
Results:
A total of 1479 children from 16 publications were included. Compared with the control group, using cold-vibrating device significantly decreased pain level above the age of 2 (MD -3.03, 95% CI: -3.38, -2.68), as well as lower anxiety level among parents (MD -1.3, 95% CI: -1.9, -0.7). Meta-regression demonstrated a significant negative correlation of pain score with age. For children at 8.5 years, cold-vibration reduced the pain score by 0.13 averagely for every increment in year compared with controls (MD -0.13; 95% CI: -0.25, -0.01). No adverse events were reported in included studies.
Discussion:
The cold-vibrating device reduced pain levels significantly among children without adverse effects. Variation of factors might contribute to the heterogeneity of our study, such as age, different needle procedures, psychological strategies…etc.
Conclusions:
Cool-vibration treatment reduced pain levels in children who underwent needle procedures and the treatment appears more effective in older children. The device is promising in clinical setting due to its non-invasiveness and ease of usage.
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