Effect of acupressure on venous access procedural pain in children: A systematic review and meta-analysis
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Published on: June 23, 2023
Seyed Javad Hosseini1, Matin Abdollahi Yousefabady2, Seyed Reza Hosseini3
1Nursing Department, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.
Insights
Acupressure significantly reduces pain during venous access procedures in children. However, the low certainty of evidence necessitates caution and further high-quality research with placebo controls.
Area of Science:
- Pediatric Pain Management
- Complementary and Alternative Medicine
Background:
- Effective pain management during venous access in children is a significant clinical challenge.
- Evidence regarding the efficacy of acupressure for pediatric venous access pain is currently inconclusive.
Purpose of the Study:
- To systematically evaluate the effectiveness of acupressure in alleviating pain associated with venous access procedures in pediatric patients.
Main Methods:
- A comprehensive literature search was performed across major electronic databases up to January 2025.
- Included randomized clinical trials (RCTs) comparing acupressure to control groups for pain during catheter insertion and venipuncture in children.
- Eight studies with 537 participants were included in the systematic review and meta-analysis.
Main Results:
- Acupressure significantly reduced pain intensity during peripheral catheter insertion and venipuncture compared to control groups (SMD: -2.30; 95% CI: -3.20 to -1.40).
- Subgroup analyses confirmed acupressure's effectiveness in decreasing pain for both peripheral catheter insertion (SMD: -1.99) and venipuncture (SMD: -2.61).
Conclusions:
- While results indicate acupressure's potential benefit, the overall evidence certainty is very low due to limited high-quality studies.
- Future research should prioritize rigorously designed RCTs with placebo controls and proper allocation concealment to strengthen the evidence base.
Background:
Effective pain management during venous access in children is a clinical priority, but evidence on acupressure remains inconclusive. This study aimed to evaluate the effectiveness of acupressure on venous access pain in children.
Methods:
A comprehensive literature search was conducted across multiple electronic databases, including PubMed, Scopus, Web of Science, CENTRAL, ClinicalTrials.gov, and Google Scholar. Relevant studies were identified using a combination of keywords related to the research objective, covering all available records up to January 15, 2025. Randomized clinical trials (RCTs) comparing the effects of acupressure on pain intensity during catheter insertion and venipuncture in children versus a control group were included in the review.
Results:
This systematic review and meta-analysis included eight studies with a total of 537 pediatric participants. The pooled analysis demonstrated that acupressure significantly reduced pain intensity during peripheral catheter insertion and venipuncture compared to the control group (SMD: -2.30; 95 % CI: -3.20 to -1.40; Z = 5.01, P < 0.001, I² = 93.6 %). Subgroup analysis further indicated that acupressure effectively decreased pain severity for both peripheral catheter insertion (SMD: -1.99; 95 % CI: -3.45 to -0.54) and venipuncture (SMD: -2.61; 95 % CI: -3.62 to -1.61), with statistically significant results.
Conclusions:
Given that only two studies met high-quality criteria and the certainty of the overall evidence remains very low, the interpretation of findings should be approached with caution. To enhance the robustness of future evidence, there is a pressing need for rigorously designed randomized trials incorporating placebo control groups and proper allocation concealment.
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