[Non pharmacologic interventions for pain associated to venipuncture in children: a literature review].

Abstract

. Non pharmacologic interventions for pain associated to venipuncture in children: a literature review.

Introduction: Venipuncture is one of the most common painful procedures performed on children. Pain prevention and control are essential in childhood, because the earlier is the nociceptive experience, the more it affects the response to subsequent painful events.

Objective: To analyse the literature on non-pharmacological methods of pain management in children undergoing venipuncture.

Method: The review was carried out between May and July 2019 by consulting the PubMed and Cochrane Database, combining Mesh terms and free text. The references reported in the articles found in the first part of the research were also analyzed, to identify further relevant studies.

Results: A total of 20 articles were included in this review (8 randomized clinical trials, 10 systematic reviews, 1 meta-analysis and 1 pilot study), on a total population of almost 20,086 children aged 1-18 years. The settings considered by the studies were pediatric wards, pediatric outpatient, and Emergency Department. Non-pharmacological interventions can be classified in 4 categories: supportive or environmental therapies; physical therapies; cognitive-behavioral therapies; and non-nutritive suction for newborns and infants. The strength of evidence ranged from high to low or extremely low.

Discussion: Most non-pharmacological methods are simple, cheap, easily acquired, and do not need excessive application time. They allow pain control and support the comfort and cooperation of children undergoing venipuncture, alone or combined to pharmacological treatment.