The Effectiveness of Bubble-Blowing as a Distraction Technique During Pediatric Intravenous Cannulation: A Randomized Controlled Trial.

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Pediatric Anesthesia Pub Date : 2025-06-09 DOI:10.1111/pan.15138

McKenna Postles, Nicholas West, Lindy Moxham, Jenna Ramji, Jade Palm, Christa Morrison, Matthias Görges, James Chen

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引用次数: 0

Abstract

Background: Intravenous cannulation is a standard but potentially painful procedure. Distraction techniques can alleviate this discomfort by shifting attention from perceived pain. Bubble-blowing is an active distraction technique that combines breathing exercises and play therapy to alleviate pain and anxiety.

Aims: To assess the effectiveness of bubble-blowing versus video-watching in reducing pain during and anxiety before pediatric intravenous cannulation.

Methods: This ethically approved, randomized controlled trial assigned 2- to 5-year-old participants to bubble-blowing or video-watching groups during their intravenous cannulations in the medical imaging department. Patients who were non-verbal, did not have an awake intravenous cannulation, received premedication, or had topical anesthetic for < 30 min were excluded. The Face Legs Activity Cry Consolability scale rated pain before, during, and after intravenous cannulation. The modified Yale Preoperative Anxiety-Short Form rated anxiety immediately following parental consent (baseline) and before intravenous cannulation.

Results: Data from 120 participants (60 females, median [interquartile range] age 3.8 [2.9-4.4] years) were available. Of these, 105 participants underwent intravenous cannulation and were included in the analysis. Pain scores during intravenous cannulation were 2.0 [0.0-7.0] in the video-watching and 2.0 [0.0-5.0] in the bubble-blowing group; median difference 0.0 (95% confidence interval (CI) -1.0 to 1.0), p = 0.888. Anxiety scores before intravenous cannulation were 36.5 [22.9-63.4] in the video-watching and 27.1 [22.9-52.1] in the bubble-blowing group; median difference 0.0 (95% CI -10.4 to 0.0), p = 0.178. Pain during intravenous cannulation increased in 29/52 (56%) children in the video-watching and 30/53 (57%) in the bubble-blowing group; odds ratio 0.97 (95% CI 0.42-2.24), p > 0.999. Anxiety increased in 27/52 (52%) children in the video-watching and 16/53 (30%) in the bubble-blowing group; odds ratio 2.48 (95% CI 1.04-6.02), p = 0.030.

Conclusion: The use of bubble-blowing as a distraction did not significantly reduce pain during or anxiety before IV cannulation compared to video-watching. However, further research is needed to explore whether active distraction techniques could be beneficial for young, neurodiverse, anxious, or fearful children.

Trials registration: This study was registered in ClinicalTrials.gov (NCT05899452; June 12, 2023).

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吹泡泡作为一种分散注意力技术在儿科静脉插管中的有效性：一项随机对照试验。

背景：静脉插管是一种标准但有潜在痛苦的手术。分散注意力技术可以通过将注意力从感知到的疼痛上转移来减轻这种不适。吹泡泡是一种积极的分散注意力的技术，它结合了呼吸练习和游戏疗法来减轻疼痛和焦虑。目的：评价吹泡泡与观看视频在减轻小儿静脉插管时疼痛和术前焦虑方面的效果。方法：这项经伦理批准的随机对照试验将2至5岁的参与者分配到吹泡泡组或视频观看组，在医学影像科进行静脉注射。非言语、未进行清醒静脉插管、接受药物前治疗或表面麻醉的患者：数据来自120名参与者（60名女性，年龄中位数[四分位数间距]3.8[2.9-4.4]岁）。其中，105名参与者接受了静脉插管，并被纳入分析。静脉置管过程中，观看视频组疼痛评分为2.0[0.0 ~ 7.0]，吹泡泡组疼痛评分为2.0 [0.0 ~ 5.0]；中位数差值0.0(95%置信区间(CI) -1.0 ~ 1.0), p = 0.888。静脉置管前，观影组焦虑评分为36.5[22.9-63.4]，吹泡泡组焦虑评分为27.1 [22.9-52.1]；中位数差异0.0 (95% CI -10.4至0.0),p = 0.178。观看视频组和吹泡泡组分别有29/52（56%）和30/53（57%）患儿静脉插管疼痛增加；优势比0.97 (95% CI 0.42-2.24), p < 0 0.999。观看视频组有27/52（52%）儿童焦虑增加，吹泡泡组有16/53（30%）儿童焦虑增加；优势比2.48 (95% CI 1.04-6.02), p = 0.030。结论：与看电视相比，吹泡泡作为一种分散注意力的方法并不能显著减轻静脉插管前的疼痛或焦虑。然而，需要进一步的研究来探索主动分心技术是否对年轻、神经多样性、焦虑或恐惧的孩子有益。试验注册：本研究已在ClinicalTrials.gov注册(NCT05899452；2023年6月12日)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Anesthesia 医学-麻醉学

CiteScore

3.20

自引率

11.80%

发文量

222

审稿时长

3-8 weeks

期刊介绍： Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.