A Comparison of Two Different Tactile Stimulus Methods on Reducing Pain of Children During Intramuscular Injection: A Randomized Controlled Study

Comparison of the effect of intramuscular injection from two different sites on pain and fear in children: a randomized controlled study

OBJECTIVE

This study aims to compare vastus lateralis and ventrogluteal site utilizations concerning pain and fear in intramuscular injection in children between 4 and 6 years of age.

METHODS

A randomized trial design was utilized in this study. Groups were randomly assigned as ventrogluteal (n=43) and vastus lateralis (n=40). Children in both groups were compared before, during, and after the procedure using the Children's Fear Scale and the Wong-Baker Faces Pain Rating Scale. Crying time was measured using a stopwatch during the procedure.

RESULTS

While the mean Children's Fear Scale total scores of the children in the ventrogluteal group were similar before the procedure, the mean Children's Fear Scale total scores during and after the procedure were significantly lower than the children in the vastus lateralis group. Wong-Baker Faces Pain Rating Scale mean scores were significantly lower in the ventrogluteal group. The mean crying time of the children in the ventrogluteal group was significantly lesser than those in the vastus lateralis group (p=0.000).

CONCLUSION

The results of the study showed that the choice of the ventrogluteal site in intramuscular injection in children between 4 and 6 years of age was effective in reducing pain, fear, and crying time.

Effects of ShotBlocker® and the Helfer skin tap technique on pain and fear experienced during intramuscular injection among children aged 6-12 years in pediatric emergency units: A randomized controlled trial

BACKGROUND

In pediatric emergency units, intramuscular injection is one of the most common procedures that cause pain and fear in children. Reducing pain and fear is important for patient comfort.

OBJECTIVE

This randomized controlled experimental study aimed to determine the effects of ShotBlocker® and the Helfer skin tap technique on the pain and fear experienced by children aged 6-12 years during intramuscular injection in pediatric emergency units.

METHODS

This study was conducted from April 2022 to October 2023 among 177 children aged 6-12 years. ShotBlocker and the Helfer skin tap technique were applied during intramuscular injection among children in the intervention groups (ShotBlocker group: n = 59, Helfer skin tap technique group: n = 59), while children in the control group received routine injections. (n = 59). The levels of pain and fear were measured.

RESULTS

In the analysis of the age distribution of the children, the average age of the Helfer skin tap technique group was found to be 8.54 ± 2.00 years; ShotBlocker group, 8.46 ± 1.99 years; and control group, 9.19 ± 2.01 years. There was a significant difference in the post-intervention Wong-Baker Pain Scale and Child Fear Scale scores based on the evaluation of the children, parents, and observer nurses between the groups (p < 0.05). The pain and fear scores of the ShotBlocker group were lower than those of the control group (p < 0.05).

CONCLUSIONS

ShotBlocker is more effective in reducing pain than the Helfer skin tap technique among children receiving intramuscular injection. These cheap and easy-to-use methods are recommended for use in emergency units.

Effectiveness of ShotBlocker application on reducing the pain of needle-related procedures in children: A systematic review and meta-analysis

PROBLEM

Needle-related procedures are quite common throughout life, especially during childhood. Pain caused by these procedures is the most common complication. ShotBlocker is an alternative non-pharmacological method to reduce pain during injection-related procedures. However, the effectiveness of the ShotBlocker application in children for reducing pain needle-related procedures remains unclear. This review aimed to evaluate the effectiveness of ShotBlocker application on pain during needle-related procedures in children from Randomized Controlled Trials.

ELIGIBILITY CRITERIA

Eight electronic databases were searched until November 2023 for articles published in English. The methodological quality and evidence strength were appraised using the Cochrane Risk of Bias 2 tool and the GRADE approach. A random-effects model was used to determine the effect of the ShotBlocker application on pain levels. The review included results involving assessments from the child, parents, and an observer in pain evaluation.

SAMPLE

A total of nine studies with 1205 children patients were included.

RESULTS

The evaluation data showed that ShotBlocker application significantly reduced the pain caused by needle-related procedures in children. The Cochrane GRADE approach showed moderate level evidence for the effect of ShotBlocker application on pain during needle procedures.

CONCLUSIONS

As a result of the studies included in this meta-analysis, it was determined that ShotBlocker application significantly reduced the pain caused by needle-related procedures in children.

IMPLICATIONS

ShotBlocker, a non-pharmacological method, can be used by pediatric nurses to reduce pain during needle-related procedures in children. Randomized controlled studies with well-designed methods are needed to create strong evidence in this field.

Utilization of local pressure devices in pain management during injections: scoping review

OBJECTIVE

to map scientific evidence regarding the use of local pressure devices in pain relief during injection procedures in patients.

METHODS

scoping review, following the recommendations of the JBI Manual for Evidence Synthesis and PRISMA-ScR, with searches conducted in the PubMed, EMBASE, CINAHL, LILACS, and PsycINFO databases, without temporal restrictions and with a cutoff date of March 2023.

RESULTS

a total of 1,514 studies were identified, with 20 articles included in the final sample. The ShotBlocker® device was utilized during subcutaneous and intramuscular injections in children and adults, proving beneficial in reducing pain, anxiety, and fear associated with the procedure.

FINAL CONSIDERATIONS

the ShotBlocker® is a low-cost, easy-to-use device that can enhance nursing clinical practice during painful procedures. However, studies involving the Brazilian Pikluc® device are scarce. Further research involving both local pressure devices is recommended.

The effects of vibration and pressure interventions on children's pain, fear and anxiety: A randomized controlled trial

AIM

The effects of vibration and pressure methods on the level of fear, anxiety, and pain of pediatric patients who were admitted to the emergency department for intramuscular injection were evaluated.

METHODS

This was a parallel group and a randomized controlled study conducted in Turkey. The study sample consisted of 114 children aged between 5 and 10 years who presented to the emergency department to receive intramuscular ceftriaxone injection as part of their treatment. The children were randomized into three groups: Vibration Intervention Group (n = 38), Pressure Intervention Group (n = 38) and Control Group (n = 38). Before the procedure, the level of anxiety and fear of the children were evaluated, and the level of perceived pain during the procedure was immediately evaluated after the intervention. Parents and nurses also rated the level of pain. Data were analyzed with non-parametric tests using SPSS version 26.0.

RESULTS

According to the evaluations made by children, mothers, and nurses, there was a significant difference between pain scores of children in the vibration and pressure intervention groups during the procedure and children in the control group (p < 0.000). There was a significant difference between anxiety and fear scores of children in the vibration and pressure groups and children in the control group before and after the intervention according to the evaluations of the children, mothers, and nurses (p < 0.000).

CONCLUSION

Vibration and pressure interventions used during intramuscular injections administered to children in the emergency department were found to reduce pain, anxiety, and fear based on the evaluations of children, mothers, and nurses.

PRACTICE IMPLICATIONS

Vibration and pressure are effective and useful in relieving pain associated with intramuscular injections in children aged between 5 and 10 years.

Effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection: An open-label randomized controlled study

BACKGROUND

Intramuscular injections, which children frequently experience during hospitalization, are one of the most significant causes of pain. Pain control is an important part of care. Therefore, it is necessary to provide practical methods in the field of nursing care to reduce injection-related pain.

AIM

This study aimed to determine the effect of the Helfer skin tap technique on pain, anxiety, and fear in children undergoing intramuscular injection.

METHOD

This randomized controlled clinical study (NCT05250804) was conducted in a pediatric emergency department between January and July 2022. A total of 64 children aged 4-10 years were randomly divided into two groups: 32 children in the Helfer skin tap group (HG), and 32 children in the control group (CG). Data were collected using the Wong-Baker FACES Pain Rating Scale, the Child Anxiety Scale-State, and the Child Fear Scale.

RESULTS

After the intramuscular injection, children in the HG had significantly lower levels of pain, anxiety, and fear than those in the CG, with mean scores of 3.25±1.50 versus 5.18±1.51, 5.87±1.56, versus 6.23±1.46, and 1.68±0.53 versus 3.15±0.76, respectively (p<0.001 for all scores).

CONCLUSION

The Helfer skin tap technique has positive effects on pain, anxiety, and fear in children during intramuscular injection. This technique can be used by nurses to reduce the pain, anxiety, and fear felt by children receiving an intramuscular injection.

Effects of two different ball types on pain and anxiety during venous blood draw in children: A randomized controlled study

BACKGROUND

Children presenting to hospitals for healthcare are often exposed to venous blood draw procedures which cause significant pain and stress for children.

OBJECTIVES

Tactile stimulation and active distraction methods can be used during procedural pain management in children. This study was conducted to determine and compare the effects of tactile stimulation and active distraction methods on levels of pain and anxiety during venous blood draw procedure in children.

METHODS

A randomized controlled study design was adopted with a parallel trial design to compare four different intervention groups with a control group. The children's anxiety levels were evaluated using the Children's Fear Scale, and their perceived pain levels were evaluated using the Wong Baker Pain Scale.

RESULTS

The results of the child and observer evaluations revealed the perceived level of pain during the procedure to be lower in the intervention groups than in the control group, and lower in the spiky ball groups than in the round ball groups. The level of anxiety during the procedure was found to be significantly lower than that recorded prior to the procedure, based on the self-evaluation of the child and the evaluation of the observer in the intervention groups. A positive correlation was found between pain and anxiety levels during the procedure.

PRACTICE IMPLICATIONS

The results of this study support the effectiveness of the spiky ball method to reduce perceived pain and anxiety in children during venous blood draw procedures in the pediatric blood draw units.

Comparison of pain levels developed during intramuscular injections to laterofemoral and ventrogluteal regions in children: a randomized controlled study

OBJECTIVE

The aim of this study was to compare the levels of pain developed during intramuscular injections to the laterofemoral and ventrogluteal regions in children.

METHODS

The study population consisted of all children aged between 7 and 12 years who presented to the pediatric emergency clinic of a hospital. The sample consisted of 62 children who met the inclusion criteria and agreed to participate in the study, and the children were randomly assigned to each group (laterofemoral n=31, ventrogluteal n=31). "Buzzy" and "deep breathing" were applied to children in both groups to relieve pain during the procedure. The data were obtained using an Information Form, a visual analog scale, and the Facial Pain Scale-Revised.

RESULTS

It was determined that the children in the ventrogluteal group during the intramuscular injections had lower visual analog scale and faces pain scale-revised scores immediately after the procedure compared with the vastus lateralis group, that is, they experienced less pain, and the difference between the two groups was significant (p<0.001).

CONCLUSION

In children, it is recommended to choose the less painful ventrogluteal region for intramuscular injection and to inform health professionals about it.