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Efficacy of Distraction for Reducing Pain and Distress Associated With Venipuncture in the Pediatric Posttransplant
Zoe G Grabinski1, Nicholas S Boscamp2, Warren A Zuckerman3
1From the Division of Pediatric Emergency Medicine, Department of Emergency Medicine.
Insights
Distraction did not reduce pain or distress during venipuncture in pediatric solid organ transplant recipients. However, phlebotomists reported higher satisfaction when distraction was used during the procedure.
Area of Science:
- Pediatric transplant medicine
- Pain management in children
- Procedural pain and distress
Background:
- Distraction is a known method for reducing procedural pain and distress.
- Its efficacy has not been previously investigated in pediatric solid organ transplant recipients.
- Venipuncture is a common and often painful procedure for these patients.
Purpose of the Study:
- To determine if distraction reduces pain and distress during venipuncture in pediatric posttransplant patients.
- To compare outcomes between children receiving distraction and those not receiving it.
Main Methods:
- A randomized controlled trial was conducted with children aged 4-17 years with solid organ transplants.
- Participants underwent venipuncture and were randomized to receive distraction or no distraction.
- Pain and distress were measured using validated scales (e.g., Faces Pain Scale-Revised).
Main Results:
- No significant difference in pain or distress scores was observed between the distraction and no-distraction groups.
- Secondary outcomes, including behavioral distress and procedural efficiency, also showed no differences.
- Phlebotomists reported increased satisfaction with venipuncture when distraction was employed.
Conclusions:
- Distraction does not appear to significantly alter pain or distress levels during venipuncture in pediatric solid organ transplant recipients.
- While not impacting patient-reported outcomes, distraction improved phlebotomist satisfaction.
- Further research may explore alternative or adjunct interventions for pain management in this population.
Objective:
Distraction can reduce pain and distress associated with painful procedures but has never been studied in children with solid organ transplants. We aimed to determine whether there is a difference in pain and distress associated with venipuncture in pediatric posttransplant patients who receive distraction compared with those who do not.
Methods:
Randomized controlled trial of children aged 4 to 17 years with solid organ transplants undergoing venipuncture in the outpatient setting. Patients were randomized to receive distraction or no distraction. The primary outcome was the Faces Pain Scale-Revised. Secondary outcomes were the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale. Exploratory outcomes included the number of venipuncture attempts, time to successful venipuncture, and satisfaction of phlebotomists and parents.
Results:
Median age of the 40 children enrolled was 11.5 years. Type of transplants included the heart (67.5%), kidney (22.5%), liver (7.5%), and more than 1 organ (2.5%). There was no difference between the Faces Pain Scale-Revised scores in distraction and no distraction groups (1.4; 95% confidence interval, 0.9-1.9; and 1.3, 95% confidence interval, 0.5-2.1, respectively). There was also no difference in the Observational Scale of Behavioral Distress-Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale scores, number of venipuncture attempts, or time to successful venipuncture. Phlebotomists were more satisfied with the venipuncture when distraction was implemented.
Conclusions:
In children with solid organ transplants, there was no difference in pain and distress associated with venipuncture between those who did and did not receive distraction. There was also no difference in other procedure-related outcomes except for greater phlebotomist satisfaction when distraction was implemented.
