Effect of communication on pain during intravenous cannulation: a randomized controlled trial.
BACKGROUND
Clinicians frequently warn patients of discomfort before potentially painful procedures, despite the lack of evidence that such communications are helpful. We aimed to compare two communications (one with, and the other without, a warning of a 'sting') immediately before i.v. cannulation in order to measure differences in perceived pain by patients during the procedure.


METHODS
Randomly assigned patients awaiting elective surgery received a communication immediately before i.v. cannulation consisting of either 'I am going to apply the tourniquet and insert the needle in a few moments. It's a sharp scratch and it may sting a little' (Group S) or 'I am going to apply the tourniquet on the arm. As I do this many people find the arm becomes heavy, numb and tingly. This allows the drip to be placed more comfortably' (Group NS). Cannulation pain was measured by a 0-10 verbal numerical rating score (VNRS) and five-point Likert scale.


RESULTS
Of 101 participants, 49 were allocated to Group S and 52 to Group NS. Median VNRS pain scores with inter-quartile ranges (IQR) were 1 and 2, respectively, for both groups. Median Likert scores were 3 in Group S and 2 in Group NS with an IQR of 1 for both groups (P = 0.13). Six participants vocalized pain in Group S and none in Group NS (P = 0.01). Three participants withdrew their arm spontaneously in Group S and none in Group NS (P = 0.11).


CONCLUSIONS
Warning patients of a 'sting' before i.v. cannulation may not be helpful.
Dutt-Gupta
J
J
Department of Anaesthesia, Royal Adelaide Hospital, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia.
Bown
T
T
Cyna
A M
AM
D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000523:psychology; D003142:Communication; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D010353:Patient Education as Topic / Q000379:methods*; D010817:Physician-Patient Relations; D011446:Prospective Studies; D014111:Tourniquets; D014473:Unconscious, Psychology