title: The efficacy of nasal tip hold-press on venous cannulation pain in children: a prospective randomized controlled study.
abstract: BACKGROUND
  Venipuncture is a common and quiet unpleasant experience for pediatric patients. The pain associated with venous cannulation disturbs the children. Different methods have been used to minimize the pain. The present study evaluated the efficacy of holding and pressing the tip of the nose on the venipuncture pain in pediatric patients.
  
  
  METHODS
  A prospective randomize controlled study carried out using the Visual Analogue Scale (YAS) for assessment cannulation pain and the Yale Preoperative Anxiety Scale (YPAS) for the assessment of anxiety before cannulation. Sixty patients aged 6 to 12 years, who needed venipuncture for general anesthesia, were divided into two groups of 30 each: a control group and a study group. Nasal tip was held and pressed during venipuncture by the parents in the study group. No intervention was done in the control group.
  
  
  RESULTS
  The YPAS scores were not different between the two groups before venous cannulation (P=0.136). Comparing the two groups. There was no difference regarding the change in HR and BP during venous cannulation. There was significantly lower cannulation pain in the study in comparison with the control group (P=0.010).
  
  
  CONCLUSIONS
  Holding and pressing the tip of the nose during venipuncture reduce the severity of venipuncture pain in pediatric patients. This could be secondary to distraction along with the physiological effect of the Valsalva maneuver on pain. Therefore, we recommend that holding and pressing the tip of the nose is a safe and effective method for reducing the severity of pain from venipuncture in pediatric patients.
authors.affiliation: Department of Anesthesia, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Maghsoudi
authors.affiliation: Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Jookar
authors.affiliation: Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hosein
authors.initials: H
authors.lastname: Haddad
authors.affiliation: Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Zoonobi
authors.affiliation: Community-Based Psychiatric Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran - mzrakhshan@gmail.com.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Rakhshan
mesh_terms: D006801:Humans; D002648:Child; D011446:Prospective Studies; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D002404:Catheterization / Q000009:adverse effects; D018962:Phlebotomy / Q000009:adverse effects / Q000379:methods; D014656:Vascular Surgical Procedures