Related Experiment Video
Updated: Feb 17, 2026
14:56
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
22.1K
Comparing Intranasal Midazolam, Oral Melatonin, and Distraction Cards for Pain and Stress Management in Pediatric
Sima Akhavan1, Sedighe Shah Hosseini2,3, Nilufar Amini4
1Pediatric Pulmonologist, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, mui.ac.ir.
Pain Research & Management
|February 16, 2026
Summary
Oral melatonin effectively reduces pain and stress during IV line insertion in children, outperforming nasal midazolam and distraction techniques. This non-pharmacological approach offers a valuable alternative for managing pediatric procedural anxiety.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Child Psychology
Background:
- Intravenous (IV) line insertion is a common pediatric procedure associated with significant pain and stress.
- The long-term impact of early painful experiences on children is recognized, yet clinical management of procedural pain and stress remains underestimated.
- Effective strategies are needed to mitigate the distress associated with IV insertion in pediatric patients.
Purpose of the Study:
- To compare the efficacy of distraction (non-pharmacological) versus oral melatonin and nasal midazolam (pharmacological) in reducing pain and stress during IV line insertion in children.
- To evaluate the effectiveness of different interventions for managing procedural pain and anxiety in pediatric patients.
Main Methods:
- A randomized controlled trial involving four groups: control, distraction, oral melatonin, and nasal midazolam.
- Pain and stress levels were assessed using a standardized questionnaire during and after IV insertion.
- Statistical analysis was performed to compare the outcomes between the intervention groups and the control group.
Main Results:
- All tested interventions (distraction, oral melatonin, nasal midazolam) showed statistically significant reductions in pain and stress compared to the control group.
- Oral melatonin demonstrated superior efficacy in reducing both pain and stress compared to nasal midazolam.
- Parental presence was found to be a significant factor in reducing children's stress and pain during IV insertion.
Conclusions:
- Oral melatonin is a highly effective method for alleviating pain and stress associated with venipuncture in children.
- The study highlights the significant benefits of oral melatonin over nasal midazolam for pediatric procedural pain management.
- Non-pharmacological methods like distraction, alongside pharmacological options, are crucial for addressing the under-treated issue of procedural pain in children.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
782
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
782
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
628
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
628
01:23Sedatives and Hypnotics: Overview
1.6K
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
1.6K