Effect of communication on pain during intravenous cannulation: a randomized controlled trial

Dutt-Gupta, J.; Bown, T.; Cyna, Allan M

doi:10.1093/bja/aem308

Cited by 73 publications

(96 citation statements)

References 28 publications

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“…Other favorable strategies, preferred by >50% of patients surveyed, such as having an additional staff member or technician present in the room, in addition to the treating physician, a pillow placed underneath their head during the injection and verbal warning or count down prior to the injection, confirmed what had been previously reported in the literature in other non-ophthalmological studies related to minimize patient’s discomfort [13–18]. …”

Section: Discussionsupporting

confidence: 75%

“…Physical comfort can reduce patient anxiety and stress as well as pain during peripheral intravenous cannulation, which led us to infer that providing patients with a neck pillow might be useful for intravitreal injections [17]. Use of a verbal warning was also investigated, but was not found to be very helpful in intravenous cannulation [18]. The goal of this study was to incorporate and evaluate strategies previously proven to minimize discomfort in several minor surgical procedures as well as to identify new strategies that may increase comfort in patients receiving repeat intravitreal injections.…”

Section: Introductionmentioning

confidence: 99%

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Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study

et al. 2016

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IntroductionMany ocular diseases require intravitreal injections of pharmacological agents. Optimizing patients’ experiences during injections is important to ensure compliance and maintenance of quality of life. The objective of this study was to identify strategies to help alleviate discomfort during intravitreal injections.MethodsA cross-sectional study surveying 128 patients during clinic visits between 2014 and 2015 in two outpatient Retina Clinics (one academic and one private). Patients receiving an intravitreal injection(s) for any retinal disorder were given a questionnaire with 10-yes/no responses for various potential strategies. Responses were stratified by sex, age (<30 years, 30–60 years, and >60 years) and total number of prior injections (0–9 injections, 10–20 injections and >20 injections).ResultsA total of 128 patients were surveyed: 59 males, 41 females and 28 with no sex specified. Our results identified four favorable strategies as those receiving more than 50% “yes” votes. These included the presence of technician/staff during the procedure, the use of a neck pillow, a verbal warning before the injection and performing injections in both eyes on the same day. Other specific strategies were identified for females, younger patients and those with greatest experience. These included: females preferred having their hand held during injections (P = 0.001) and using a stress ball (P = 0.000) when compared to males. Stratifying by age, patients 30–60 years old preferred having their hand held (P = 0.008) and background music (P = 0.007). Stratifying by prior injections, patients with >20 prior injections preferred having their hand held (P = 0.001), using a stress ball (P = 0.021) and, if necessary, having bilateral injections performed the same day to improve comfort (P = 0.037).ConclusionsHaving an extra staff member present during the injection, having a neck pillow, having a verbal warning prior to injection and having both eyes injected on the same day were indicated as favorable strategies by over half of those surveyed. Further, specific strategies were identified for females, younger patients (30–60 years old) and those with greatest experience (>20 injections).

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study

et al. 2016

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“…It did not affect subsequent pain ratings but increased significantly subsequent anxiety ratings. In a prospective randomized study, wording during insertion of an IV cannula was compared in its effects (Dutt-Gupta, Bown, & Cyna, 2007). One group was told: “I am going to apply the tourniquet and insert the needle in a few moments.…”

Section: The Settingmentioning

confidence: 99%

Helping Children Cope With Medical Tests and Interventions

Lang¹,

Viegas

Bleeker³

et al. 2017

Journal of Radiology Nursing

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Medical procedures and tests become a challenge when anxiety and pain make it difficult for the patient to cooperate or remain still when needed. Fortunately a short intervention with hypnoidal language at the onset of a procedure induces a positive and sustained change in the way pain and anxiety are processed. While anesthesia may appear to be a simple solution to eliminate pain, the adverse effects of pre-anesthesia anxiety on postoperative behavior and recovery are often not fully appreciated. This paper discusses options for self-hypnotic relaxation that are applicable to interactions with children. The high suggestibility of children makes it relatively easy to engage them in make-believe scenarios. Avoidance of negative suggestions is key in avoiding nocebo effects that may be difficult to overcome later. Once a child is immersed in his or her preferred scenario or hobby/activity of choice, environmental and procedural stimuli can be easily integrated in the imagery. Ego-strengthening metaphors that tie in features of strength, confidence, or resilience are particularly empowering. Even when children are fully under general anesthesia they may still have recall of what is said in the room and therefore caution in word choice should be maintained.

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“…9 The work of Dr. Alan Cyna has provided evidence to suggest the role of communication and the power of suggestive words in altering patients' perception of unpleasant sensations. [21][22][23] In meditation, patients strive to suspend their ''normal'' flow of thoughts for a period of time in an attempt to reduce their stress levels and slow their vital signs.…”

Section: Mind-body and Energy Therapiesmentioning

confidence: 99%

“…Similarly, in the perioperative setting, while it is not necessary to have formal training in hypnosis, communicating with patients in a soothing and reassuring manner can bring about beneficial results. [21][22][23] Other CAM therapies for pain may also offer surprising benefit at minimal risk to those patients who are amenable. These therapies should probably be tried prior to initiation of opioid therapy or more invasive procedures for chronic pain.…”

Section: Conclusion: Practical Information For Anesthesiologists Andmentioning

confidence: 99%

Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review

Woodbury

Soong

Fishman

et al. 2015

Can J Anesth/J Can Anesth

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Effect of communication on pain during intravenous cannulation: a randomized controlled trial

Abstract: Warning patients of a 'sting' before i.v. cannulation may not be helpful.

Cited by 73 publications

References 28 publications

Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study

Strategies for Improving Patient Comfort During Intravitreal Injections: Results from a Survey-Based Study

Helping Children Cope With Medical Tests and Interventions

Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review

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