Vibration associated with cryotherapy to relieve pain in children

Mendes-Neto, José Marden; Santos, Sandra Lauton

doi:10.5935/2595-0118.20200012

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REVIEW ARTICLE • BrJP 3 (1) • Jan-Mar 2020 • https://doi.org/10.5935/2595-0118.20200012 copy

Vibration associated with cryotherapy to relieve pain in children

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

The administration of intramuscular drugs and peripheral venous puncture are procedures that use needles cause pain, especially in children. This painful experience generates distress, phobia, tachycardia, refusal to further treatments, anxiety, and sadness in parents. The use of non-pharmacological methods such as vibration and cold for pain relief in children has become a reliable alternative. The objective of this study was to evaluate the association between vibration and cryotherapy as a strategy for the relief of pain in children undergoing procedures with the use of needles.

This is an integrative review, in which articles were searched in the Pubmed, Medline, BDENF and LILACS databases, using the descriptors: “Child”, “Vibration”, “Cryotherapy” and “Pain” associated with the Boolean operator “and”. After the selection and reading of the articles in full, they were systematically synthesized and classified with a level of scientific evidence 2. Studies have shown that the association between vibration and cryotherapy is effective in reducing pain in children with or without cognitive alterations, also reducing their and parents’ anxiety during procedures performed with needles.

CONCLUSION:

The implementation of vibration associated with cryotherapy during the administration of injectable drugs and the installation of a peripheral venous device can reduce the fear, anguish, and anxiety in children, calming the parents and benefiting health professionals.

Keywords:
Child; Cryotherapy and pain; Vibration

Code	Authors	Origin	Objectives	Methods
N1	Bergomi et al.²2 Bergomi P, Scudeller L, Pintaldi S, Dal Molin A. Efficacy of non-pharmacological methods of pain management in children undergoing venipuncture in a pediatric outpatient clinic: a randomized controlled trial of audiovisual distraction and external cold and vibration. J Pediatr Nurs. 2018;9(42):e66-72.	Italy	Evaluation of vibration associated with cryotherapy with or without the use of cartoons to relieve pain in children undergoing venipuncture. Evaluation of parents' anxiety regarding these pain relief interventions.	150 binomials (5-12-year-old children and their parents) were randomly divided into four groups: 1. control group, which did not undergo any pain relief intervention, 2. Buzzy ^® group, 3. Buzzy^® group associated with drawing and 4. cartoon group. All children underwent peripheral venipuncture.
N2	Redfern, Chen and Sibrel²⁰20 Redfern RE, Chen JT, Sibrel S. Effects of thermomechanical stimulation during vaccination on anxiety, pain, and satisfaction in pediatric patients: a randomized controlled trial. J Pediatr Nurs. 2018;38:1-7.	United States States	To determine if vibration associated with cryotherapy was able to relieve pain in children undergoing immunization.	Fifty children and adolescents (5-18 years old) were randomly divided into two groups: 1. group using Buzzy^® and 2. group without the device, both submitted to immunization by intramuscular route.
N3	Moadad et al.³3 Moadad N, Kozman K, Shahine R, Ohanian S, Badr LK. Distraction using the BUZZY for children during an IV insertion. J Pediatr Nurs. 2016;31(1):64-72	United States States	To investigate the use of vibration and cryotherapy in pain relief during peripheral venous catheter insertion in children.	48 dyads (children aged 4 to 12 years and their mothers) were randomly divided into two groups: 1. control group (not exposed to Buzzy^®) and 2. group using Buzzy^® . Both groups were comprised children whose treatment required passing a peripheral venous catheter.
N4	Schreiber et al.²¹21 Schreiber S, Cozzi G, Rutigliano R, Assandro P, Tubaro M, Cortellazzo Wiel L, et al. Analgesia by cooling vibration during venipuncture in children with cognitive impairment. Acta Paediatr. 2016;105(1):e12-6.	Italy	To test the effectiveness of using cryotherapy associated with vibration to relieve the pain induced by peripheral venipuncture in children with cognitive impairment.	71 children with cognitive impairment were randomly allocated to two experimental groups: 1. control, in which they were not exposed to Buzzy^® and group 2 children submitted to Buzzy^® . Both groups underwent peripheral venous device installation.
N5	Canbulat Sahiner et al.¹⁴14 Canbulat Sahiner N, Inal S, Sevim Akbay A. The effect of combined stimulation of external cold and vibration during immunization on pain and anxiety levels in children. J Perianesth Nurs. 2015;30(3):228-35.	Turkey	To determine the effect of cryotherapy associated with vibration in relieving the pain and anxiety triggered by immunization against diphtheria, tetanus, and infections caused by pertussis in children.	104 school-age children (up to 7 years old) were randomly divided into two groups by a computer program: 1. control group that was not exposed to Buzzy^® and 2. group that was subjected to Buzzy^® . The pain stimulus was established by the administration of the vaccine (DTP) to the deltoid muscle, 5cm above the site of the Buzzy^® device.
N6	Canbulat, Ayhan and Inal²²22 Canbulat N, Ayhan F, Inal S. Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients. Pain Manag Nurs. 2015;16(1):33-9.	Turkey	Evaluation of the effect of cryotherapy associated with vibration on pain and anxiety in children undergoing peripheral venous catheter installation.	176 children aged 7 to 12 years were randomly divided into two groups using a computer program: a control group, which was not exposed to Buzzy ^®, and the group with Buzzy^® , 5cm above the peripheral venipuncture site.
N7	Inal and Kelleci²³23 Inal S, Kelleci M. Relief of pain during blood specimen collection in pediatric patients. MCN Am J Matern Child Nurs. 2012;37(5):339-45.	Turkey	To investigate the effect of cryotherapy associated with vibration to relieve the pain and reduce the anxiety in children during blood collection for laboratory tests.	120 children from 6 to 12 years of age were randomly divided into two groups: 1 control group that was not stimulated with Buzzy ^® and group 2, with children submitted to Buzzy^® , both groups underwent the installation of a venous catheter to collect blood.
N8	Baxter et al.¹⁸18 Baxter AL, Cohen LL, McElvery HL, Lawson ML, von Baeyer CL. An integration of vibration and cold relieves venipuncture pain in a pediatric emergency department. Pediatr Emerg Care. 2011;27(12):1151-6.	United States States	To test the effectiveness of cryotherapy associated with vibration in relieving pain and anxiety in children and adolescents undergoing peripheral venipuncture for blood collection.	81 children and adolescents aged 4 to 18 years were randomly divided into two experimental groups: 1. control group, which was not stimulated with Buzzy ^® and 2. group exposed to Buzzy^® . Both underwent the installation of a peripheral venous catheter to collect blood.

Code	Strategies	Main results
N1	The vibration associated with cryotherapy was induced by the Buzzy ^® device, whether or not associated with the cartoon. The perception of pain in children was assessed by the Wong-Baker faces scale, which was also used by nurses who performed the procedure. The nurses also assessed the pain in children using the emotional manifestation scale. Parents' anxiety was assessed using the numerical scale from zero to 10.	The vibration associated with cold and cartoons minimized the pain in children submitted to venipuncture. These pain control interventions also contributed to reducing parents' anxiety.
N2	Vibrating stimulation and cryotherapy were established by Buzzy^® . The pain was measured in the groups using the Wong-Baker faces scale, and a modification of this scale allowed the assessment of children's anxiety. Parents' satisfaction was investigated based on the experience with the study by applying a questionnaire and assigning a score that ranged from poor to excellent.	Anxiety showed no difference between the groups. The pain was much lower in the vibration and cold group compared to the control group. There was no statistical difference in the assessment of parents' satisfaction between the groups.
N3	The pain stimulus was established by peripheral venipuncture. And thermal (cryotherapy) and vibration stimulation were promoted by the Buzzy^® device. Pain assessment in children occurred by applying the Wong-Baker faces scale by researchers, parents, and the nurse who installed the peripheral device. These answers were compared.	Vibration associated with cryotherapy was effective in reducing pain in children undergoing peripheral venous device insertion. The researchers, nurses, and parents' assessment was similar in attesting pain relief in these children.
N4	The pain was induced by the installation of a peripheral venous catheter, and the Buzzy^® device was used to cause the vibration associated with cryotherapy. Pain assessment was measured using the pain verification scale in non-communicative children, surgery version.	Children who received vibration associated with cryotherapy showed a reduction in pain in the peripheral venous catheter installation.
N5	The pain was promoted by intramuscular vaccine administration and the vibration stimulation associated with cryotherapy was provided by the Buzzy ^® device in both groups. Each child was assessed for pain by two examiners: one nurse who applied the vaccine and one researcher using the Wong-Baker faces scale and verbal pain report. Anxiety was assessed using the child's fear scale.	The association of the vibration stimulation and cryotherapy was effective in reducing pain and anxiety in children undergoing immunization against diphtheria, tetanus, and infections caused by pertussis.
N6	The Buzzy^® device was used for vibration stimulation associated with cold. Pain stimulation and anxiety were stimulated by the insertion of a peripheral venous catheter. Pain assessment was conducted using the Wong-Baker faces scale and the visual analog scale. The child's anxiety was assessed by their parents based on behavioral and verbal analysis.	The application of cryotherapy associated with vibration is effective in reducing the pain and anxiety in children, generated by the venipuncture necessary to pass a peripheral venous catheter.
N7	The vibration stimulus associated with cryotherapy was given with the Buzzy^® device, 5cm above the puncture site throughout the procedure. Anxiety and pain were assessed by the anxiety and pain scales, as well as by the revised faces scale applied by the researchers.	The group using the Buzzy^® device showed reduced anxiety and pain compared with the control group.
N8	Buzzy^® was the device used for vibration stimulation associated with cryotherapy, placed 5cm above the puncture site. Anxiety and pain were assessed by the anxiety and pain scales for children, both applied by the researchers.	Low temperature associated with vibration reduced the pain in children and adolescents undergoing peripheral venipuncture compared to the control group that received no stimulation.

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[1] Correspondence to: Av. Marechal Cândido Mariano Rondon, s/n - Roza Elze 49100-000 São Cristóvão, SE, Brasil. E-mail: marden.mendes21@gmail.com

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Vibration associated with cryotherapy to relieve pain in children

ABSTRACT

BACKGROUND AND OBJECTIVES:

CONTENTS:

CONCLUSION: