The efficacy of non-pharmacological methods of pain management in school age children receiving venepuncture in a paediatric department: a randomized controlled trial of audiovisual distraction and routine psychological intervention

Questions under study/principles: Non-pharmacologic analgesia has been demonstrated to alleviate pain and distress in invasive procedures. Nevertheless, the practice has not been adopted widely in paediatric departments because nurses are often too busy to perform a time consuming procedure. Methods: Three hundred patients (8-9 years) requiring venepuncture for intravenous treatment were randomized into audiovisual distraction group (n = 100, watching cartoon films), intervention group (n = 100, receiving psychological intervention) and control group (n = 100, without any intervention). Results: There was no significant difference (P >0.05) between the audiovisual distraction and the intervention groups for cooperation, venepuncture times and pain intensity (assessed with visual analogue scale, VAS). However, cooperation in the control group was more passive than in the intervention group (P <0.05) but not apparently different to the audiovisual distraction group (P >0.05). Venepuncture time was significantly higher in the control group than in the other two groups (P <0.05). Venepuncture caused moderate pain in children (VAS score: 5.22 +/- 2.53 in the control group). VAS scores indicated that procedures were more painful in the control group than in the audiovisual distraction or the intervention group (VAS score: 4.55 +/- 2.26 and 4.38 +/- 2.32 in the audiovisual distraction and intervention groups respectively, P <0.05). Conclusions: Audiovisual distraction was demonstrated to be effective in reducing self-reported pain, improving patient cooperation and increasing success rate in venepuncture procedures and was as successful as routine psychological intervention. It is highly recommended as an effective, labour saving and easy to administer analgesia and should be used to help prevent pain from venepuncture in school age children.