JNSS 2025, 16(1):4-14 | DOI: 10.32725/jnss.2025.008

COMPARISON OF FOUR NON-PHARMACOLOGICAL METHODS OF PAIN RELIEF DURING VENIPUNCTURE IN CHILDREN

Marie Lulková^{1, 2, *}, Iva Brabcová¹, Jaroslav Škvor²

¹ University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, České Budějovice, Czech Republic

² Department of Pediatrics, Masaryk Hospital, Krajská zdravotní, a.s., affiliated with the Faculty of Health Studies, Jan Evangelista Purkyně University, Ústí nad Labem, Czech Republic

Introduction: Venipuncture is a standard invasive procedure in children that causes pain, leading to procedural anxiety. It emphasises the clinical importance of adequate analgesia and the need to identify effective non-pharmacological procedures. Goal: This study primarily aims to comparatively evaluate the analgesic efficacy of four non-pharmacological interventions: Buzzy® vibrating device, local cooling, felinotherapy, and oral stimulation with a lollipop - compared to standard care (control group) in children aged 4-11 years undergoing venipuncture. The secondary goal was to compare the assessment of pain intensity by the child and the parent.

Methods: A prospective five-arm randomised controlled trial included 125 children (25 in each arm). The child and the parent assessed pain intensity immediately after the procedure using the Wong-Baker face scale (WBF 0-5). One-factor analysis of variance (ANOVA) with post-hoc Tukey's test (α = 0.05) was used to compare the mean values of the Wong-Baker face scale between groups.

Results: The Buzzy® device showed the lowest average pain value according to the children (WBF 1.96 ± 0.90) and was significantly more effective than the lollipop and the control group (p < 0.05). Local cooling (WBF 2.50 ± 1.16) was the second most effective method. The effect of felinotherapy (WBF 2.71 ± 1.16) was not statistically different from the control group (WBF 2.96 ± 1.31). Oral stimulation with a lollipop (WBF 3.79 ± 1.08) was the least effective. According to their perception, parents systematically underestimated children's pain (average difference in WBF -0.96 points). Neither the age nor the gender of the children influenced the effectiveness of the interventions.

Conclusion: Buzzy® vibrating device is the most effective researched non-pharmacological intervention for reducing pain during venipuncture in children aged 4-11 years. Local cooling is also an effective and affordable alternative.

Keywords: Buzzy; Felinotherapy; Non-pharmacological methods; Paediatric analgesia; Procedural pain; Venipuncture

Grants and funding:

The research was financed with the help of a grant from Krajská zdravotní, a.s. (project No. IGA-KZ-2019-1-2).

Conflicts of interest:

The authors have no conflict of interest to declare and confirm that all photographs used in this study were taken with the informed consent of the participants.

Received: June 3, 2025; Accepted: July 10, 2025; Published: July 10, 2025  Show citation