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Original Articles

Pain assessment in venepuncture among children: Experience from a single centre study in Sri Lanka

Authors:

K. D. N. Silva ,

Base Hospital Kekirawa, LK
About K. D. N.
Paediatrician
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I. Kankananarachchi,

University of Ruhuna, LK
About I.
Consultant Paediatrician and Senior Lecturer, Department of Paediatrics, Faculty of Medicine
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I. L. A. N. Darshana,

University of Ruhuna, LK
About I. L. A. N.
Lecturer, Department of Community Medicine, Faculty of Medicine
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W. N. D. De Silva,

Teaching Hospital, Karapitya, LK
About W. N. D.
Nursing Officer, Quality Management Unit
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N. Liyanarachchi

University of Ruhuna
About N.
Consultant Paediatrician and Senior Lecturer, Department of Paediatrics, Faculty of Medicine
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Abstract

Introduction: Venepuncture is the commonest and feared painful experience in hospitalized children.


Objectives: To assess the venepuncture pain (VP) status and associated factors among children admitted to paediatric units in Teaching Hospital Karapitiya (THK).


Method: A cross-sectional study was conducted among 300 children aged 2 months to 8 years, who underwent venepuncture in above setting in 2021. Data were collected by direct observation of the procedure and by administering a questionnaire to primary caregivers. Pain scores were documented using the Face, Legs, Activity, Cry and Consolability (FLACC) pain scoring system on an ordinal scale (0-10). The median pain scores among groups were compared using Mann Whitney U test. The level of significance was considered as 0.05.


Results:Of the observed 300 venepunctures, 71 (23.6%) were blood samples and 229 (76.3%) were intravenous cannulations. The median (IQR) VP score was 6 (2).  There was zero practice of assessment and documentation of VP using a pain scale. The practice of multimodal pain management (MPM) was observed only in 9 (3%), while 24 (8%) children did not receive any VP management. Two hundred and sixty (86.7%) parents were not satisfied with existing pain management, while 239 (79.7%) parents expected more actions to improve the practice, including MPM (80%, n=192). Of suggested methods, anaesthetic gel application before venepuncture (87.7%, n=263) was identified as the highest expected method. Statistically significant higher pain scores were associated with younger age groups (p = 0.000), being a single child (p = 0.002), increased number of attempts (p = 0.000) and longer duration of procedure (p = 0.000) in Mann Whitney U test.


Conclusions: In this study, statistically significant higher pain scores were associated with younger age groups, being a single child, increased number of attempts and longer duration of procedure.


Sri Lanka Journal of Child Health, 2022; 51(3): 369-376

How to Cite: Silva, K.D.N., Kankananarachchi, I., Darshana, I.L.A.N., De Silva, W.N.D. and Liyanarachchi, N., 2022. Pain assessment in venepuncture among children: Experience from a single centre study in Sri Lanka. Sri Lanka Journal of Child Health, 51(3), pp.369–376. DOI: http://doi.org/10.4038/sljch.v51i3.10225
Published on 05 Sep 2022.
Peer Reviewed

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