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Randomized Controlled Trial
. 2021 Oct 1;37(10):e621-e624.
doi: 10.1097/PEC.0000000000002424.

An Evaluation of High Preprocedural Anxiety and Venipuncture Pain Experienced by Young Children

Maren M Lunoe  1 , Ashley E Bolin  2 , Amy L Drendel  3
Affiliations
Randomized Controlled Trial

An Evaluation of High Preprocedural Anxiety and Venipuncture Pain Experienced by Young Children

Maren M Lunoe et al. Pediatr Emerg Care. .

Abstract

Objective: The aim of this study was to determine if young children with high preprocedural anxiety experience increased pain at venipuncture.

Methods: This was secondary analysis of prospectively obtained data from a randomized controlled trial comparing vapocoolant spray with jet-injected lidocaine for venipuncture pain. Children aged 1 to 6 years were enrolled and videotaped. Videos were reviewed and scored for anxiety using the modified Yale Preoperative Anxiety Scale score for preprocedural anxiety (score range, 23-100). High anxiety was defined as greater than 40. Pain at the time of venipuncture was scored using the Face, Legs, Activity, Cry, and Consolability scale (score range 0-10). Moderate to severe pain was defined as greater than 3. Logistic regression assessed patient factors associated with high preprocedural anxiety and evaluated the relationship between preprocedural anxiety and pain during venipuncture.

Results: Two hundred five patients were enrolled; 59.5% of patients were male, and 53.7% were White. Mean age was 3.2 years. Prior to the procedure, 67% of patients had high anxiety. Patient age, race, sex, and previous venipuncture were not associated with increased odds of high anxiety. Moderate to severe pain at venipuncture was observed in 65% of children. High preprocedural anxiety was associated with increased odds of moderate to severe pain at venipuncture when controlled for patient characteristics (adjusted odds ratio, 4.62; 95% confidence interval, 2.03-8.54).

Conclusions: Most young children undergoing venipuncture experienced high preprocedural anxiety. Children with high preprocedural anxiety had increased odds of moderate to severe pain at venipuncture. Anxiety-reducing interventions should be explored to reduce pain experienced during venipuncture.

Trial registration: ClinicalTrials.gov NCT01890642.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

    1. Cohen LL. Behavioral approaches to anxiety and pain management for pediatric venous access. Pediatrics . 2008;122(suppl 3):S134–S139.
    1. Kennedy RM, Luhmann J, Zempsky ET. Clinical implications of unmanaged needle-insertion pain and distress in children. Pediatrics . 2008;122(suppl 3):S130–S133.
    1. Fradet C, McGrath PJ, Kay J, et al. A prospective survey of reactions to blood tests by children and adolescents. Pain . 1990;40:53–60.
    1. Rhudy JL, Meagher MW. Fear and anxiety: divergent effects on human pain thresholds. Pain . 2000;84:65–75.
    1. Kivrak Y, Kose-Ozlece H, Ustundag MF, et al. Pain perception: predictive value of sex, depression, anxiety, somatosensory amplification, obesity, and age. Neuropsychiatr Dis Treat . 2016;2016:1913–1918.

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