title: Analgesia by cooling vibration during venipuncture in children with cognitive impairment.
abstract: OBJECTIVE
  Children with cognitive impairment experience pain more frequently than healthy children and are more likely to require venipuncture or intravenous cannulation for various procedures. They are frequently unable to report pain and often receive poor pain assessment and management. This study assessed the effectiveness of physical analgesia during vascular access in children with cognitive impairments.
  
  
  METHODS
  We conducted a prospective randomised controlled study at a tertiary-level children's hospital in Italy from April to May 2015 to assess whether a cooling vibration device called Buzzy decreased pain during venipuncture and intravenous cannulation in children with cognitive impairment. None of the children had verbal skills and the main cognitive impairments were cerebral palsy, epileptic encephalopathy and genetic syndromes.
  
  
  RESULTS
  We tested 70 children with a median age of nine years: 34 in the Buzzy group and 36 in the no-intervention group. Parents were trained in the use of the Noncommunicating Children's Pain Checklist--postoperative version scale, and they reported no or mild procedural pain in 32 cases (91.4%) in the Buzzy group and in 22 cases (61.1%) in the no-intervention group (p = 0.003).
  
  
  CONCLUSIONS
  Cooling vibration analgesia during vascular access reduced pain in children with cognitive impairment.
authors.affiliation: Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Schreiber
authors.affiliation: Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cozzi
authors.affiliation: Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Rutigliano
authors.affiliation: University of Torino, Torino, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Assandro
authors.affiliation: University of Trieste, Trieste, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Tubaro
authors.affiliation: University of Trieste, Trieste, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Cortellazzo Wiel
authors.affiliation: Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Clinical Epidemiology and Health Services Research Unit, Trieste, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ronfani
authors.affiliation: Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy.
authors.forename: Egidio
authors.initials: E
authors.lastname: Barbi
mesh_terms: D000293:Adolescent; D000698:Analgesia / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders; D017679:Cryotherapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D059408:Pain Management / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D018962:Phlebotomy / Q000009:adverse effects*; D011446:Prospective Studies; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*
keywords: Children; Cognitive impairment; Cooling vibration; Needle pain; Vascular access