Article type
Abstract
Background: Needle-related pain, including procedures like venipuncture and intramuscular injections, is a common adverse event. Untreated pain in children not only causes immediate discomfort but is also linked to future procedural fear and anxiety. Various pharmacological interventions, such as EMLA and lidocaine, effectively reduce needle-induced pain in children, but there is currently a lack of comparison between these interventions.
Objective: The aim of this study is to evaluate and compare the effects of different pharmacological interventions in reducing needle-related pain in children using a network meta-analysis.
Methods: PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL were searched from database inception until June 2023 to obtain randomized controlled trials (RCTs). The risk of bias of the RCTs included in this study was assessed according to the Risk of Bias 2 tool. STATA 17 was used to construct a network diagram, league figures, and the final surface under the cumulative ranking curve (SUCRA) values. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Results and Conclusions: A total of 113 RCTs were included in the study, involving 14 pharmacological interventions. Network meta-analysis showed that compared with placebo, nitrous oxide (SMD = -2.61; 95% CI = -3.60 to -1.61; SUCRA = 94.6%), sweet solution (SMD = -2.25; 95% CI = -4.44 to -0.07; SUCRA = 81.5%), amethocaine (SMD = -1.42; 95% CI = -2.62 to -0.21; SUCRA = 66.2%), EMLA cream (SMD = -1.27; 95% CI = -1.82 to -0.72; SUCRA = 63.2%), EMLA patch (SMD = -1.22; 95% CI = -2.33 to -0.11; SUCRA = 58.9%), and lidocaine (SMD = -1.14; 95% CI = -1.68 to -0.60; SUCRA = 54.0%) all significantly reduced self-reported pain in children compared with placebo.
Conclusions: Pharmacological interventions such as nitrous oxide and sweet solutions demonstrate positive effects for reducing needle-related pain in children. Our study provides evidence to support the reduction of needle-related pain in children.
Funding: This work is supported by the Major Project of the National Social Science Fund of China (19ZDA142).
Objective: The aim of this study is to evaluate and compare the effects of different pharmacological interventions in reducing needle-related pain in children using a network meta-analysis.
Methods: PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL were searched from database inception until June 2023 to obtain randomized controlled trials (RCTs). The risk of bias of the RCTs included in this study was assessed according to the Risk of Bias 2 tool. STATA 17 was used to construct a network diagram, league figures, and the final surface under the cumulative ranking curve (SUCRA) values. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
Results and Conclusions: A total of 113 RCTs were included in the study, involving 14 pharmacological interventions. Network meta-analysis showed that compared with placebo, nitrous oxide (SMD = -2.61; 95% CI = -3.60 to -1.61; SUCRA = 94.6%), sweet solution (SMD = -2.25; 95% CI = -4.44 to -0.07; SUCRA = 81.5%), amethocaine (SMD = -1.42; 95% CI = -2.62 to -0.21; SUCRA = 66.2%), EMLA cream (SMD = -1.27; 95% CI = -1.82 to -0.72; SUCRA = 63.2%), EMLA patch (SMD = -1.22; 95% CI = -2.33 to -0.11; SUCRA = 58.9%), and lidocaine (SMD = -1.14; 95% CI = -1.68 to -0.60; SUCRA = 54.0%) all significantly reduced self-reported pain in children compared with placebo.
Conclusions: Pharmacological interventions such as nitrous oxide and sweet solutions demonstrate positive effects for reducing needle-related pain in children. Our study provides evidence to support the reduction of needle-related pain in children.
Funding: This work is supported by the Major Project of the National Social Science Fund of China (19ZDA142).