Comparison of Local Heat and Massage on the Outcomes of Venous Cannulation in Hospitalized Children with Difficult Venous Access: A Randomized Controlled Trial.

Abstract

Peripheral venous cannulation is a common invasive procedure with a high failure rate, particularly challenging in children and young patients due to their unique anatomical characteristics. This study evaluated the effectiveness of local heat and massage in facilitating venous access in hospitalized children with difficult access. A single-blind randomized controlled trial was conducted at Children's Hospital in Tabriz from December 20, 2023, to May 9, 2024. Ninety-six children aged 6 to 12 years were enrolled and randomly assigned to three groups: two intervention groups and one control group. In the first intervention group, an electric heating pad at 40 ± 2 degrees Celsius was applied to the venous access site for 5 minutes. In the second intervention group, a gentle circular massage from the wrist to the cubital fossa was performed for at least 2 minutes. Outcomes included pain scores using the Visual Analogue Scale (VAS), time spent, and number of attempts for venous access, along with vein assessment using the Vein Assessment Scale (VAS). Data were analyzed using SPSS version 23. No significant differences were found in demographic factors among the groups (p > .05). The vein assessment showed improved visibility and palpability with local heat and massage. Pain scores significantly decreased in both intervention groups (p ≤ .001), with the local heat group reporting lower mean pain scores and shorter cannulation duration compared to the massage group (p ≤ .001). No significant differences were observed in the frequency of cannulation attempts (p > .05). Applying local heat and massaging the venous cannulation site prior to venous cannulation significantly increases the ease of venous access. However, in a comparison of these two methods, local heat was more effective than massage in reducing perceived pain in children with difficult access. Therefore, using local heat can be recommended as a simple and cost-effective intervention.