Pain- and distress-reducing interventions for venepuncture in children.
OBJECTIVE
To compare the effect of eutectic mixture of local anaesthetics (EMLA) and a placebo cream on reported pain and observed distress associated with venepuncture, and to investigate effects of procedural information before and distraction during venepuncture.


METHODS
Children 3-12 years of age undergoing venepuncture under five experimental and a control condition reported their pain at venepuncture on visual scales. Distress was observed when the child entered the waiting room, just before, and during venepuncture.


RESULTS
Distress increased over the measurement occasions, but a distress-reducing effect of EMLA only was found at the actual venepuncture. The placebo diminished the reported pain, but the effect of EMLA was larger. Procedural information and distraction showed no effects.


CONCLUSIONS
EMLA reduces pain from venepuncture. The placebo effect probably results from desirable responding. Behavioural distress is a more direct measure than self-reported pain. More sophisticated designs should be used for the provision of procedural information and distraction.
Tak
J H
JH
van Bon
W H J
WH
D000777:Anesthetics; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008012:Lidocaine; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D009824:Ointments; D010146:Pain / Q000517:prevention & control*; D018962:Phlebotomy / Q000009:adverse effects* / Q000523:psychology; D010919:Placebos / Q000627:therapeutic use; D011318:Prilocaine; D002666:Psychology, Child; D013315:Stress, Psychological / Q000517:prevention & control*; D016896:Treatment Outcome
D000777:Anesthetics; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D010919:Placebos; D011318:Prilocaine; D008012:Lidocaine