[Comparison of EMLA cream versus local refrigeration forreducing venipuncture-related pain in pediatric patients of children's medical center, 2008]

ABSTRACT

Venipuncture is one of the most painful procedures in hospitalized children and reducing the pain is an important aim of nursing interventions. This study was designed to compare effectiveness of EMLA cream and local refrigeration on reducing venipuncture-related pain in hospitalized children in Children's Medical Center. An interventional study was conducted with 90 hospitalized children ranging in age from 3 to 12 years old who had venipuncture in urology unit of Children's Medical Center. They were randomly allocated in three groups of intervention with EMLA cream, intervention with local refrigeration, and nonintervention groups. The first two groups received the interventions prior to venipuncture. Pain intensity was measured after venipuncture through FACES, a self-report scale and CHEOPS scale for Nurse's observations. All statistics were computed using the SPSS software, using parametric and nonparametric statistical tests, Mann-Whitney and Kruskal-Wallis tests. The mean and standard deviation of pain intensity scores based on FACES scale in EMLA, local refrigeration and control groups were 3.26 +/- 2.79, 8.23 +/- 2.39 and 7.06 +/- 2.27, respectively. The corresponding values for CHEOPS scale were 7.40 +/- 2.15, 4.26 +/- 2.81 and 9.35 +/- 2.17. The between groups difference was statistically significant according to both scales [p<0.00] EMLA and local refrigeration significantly reduced the venipuncture-related pain, compared to controls. There was no significant difference between EMLA and refrigeration groups in reducing the pain. Both refrigeration and EMLA are effective on reducing venipuncture-related pain in children. So, refrigeration, as a non pharmacological, cost effective, and available method, is recommended to manage procedural pain in pediatric patients