DR CHETHAN S,DR. JANANI M Z,DR. KOUSALYA K S,DR. PRIYA DARSNI MUTHUKRISHNAN,DR. SUENERA P V,DR.MUTHULINGAM VIVEK
DOI: https://doi.org/Background: Intravenous (IV) cannulation is a common but distressing procedure in pediatric care, particularly in young children. While topical anesthetics such as EMLA cream reduce sensory pain, they often fail to address behavioral distress. Animated distraction has emerged as a promising non-pharmacological alternative. However, limited data exist on their combined use in preschool-aged children.
Objective: To compare the effectiveness of animated distraction, topical anesthesia (EMLA), and their combination in reducing pain and procedural distress during IV cannulation in children aged 1 to 5 years.
Methods: In this randomized controlled trial, 180 children aged 1–5 years requiring IV cannulation were randomly assigned into three groups: animated distraction only, topical anesthesia only, and a combination of both. Pain was assessed using the FLACC (Face, Legs, Activity, Cry, Consolability) scale. Secondary outcomes included crying duration, cooperation, cannulation time, success rates, adverse events, and parental satisfaction. Multivariate regression identified predictors of lower pain scores.
Results: The combination group had the lowest mean FLACC score (2.6 ± 1.4) compared to animated distraction (3.2 ± 1.6) and topical anesthesia (5.8 ± 2.1) (p < 0.001). Mild pain (FLACC < 4) was most frequent in the combination group (71.7%). The combination also resulted in significantly shorter crying duration (28.9 ± 12.7 seconds), faster cannulation (70.8 ± 18.9 seconds), higher first-attempt success rate (93.3%), better cooperation (9.1 ± 0.9), and highest parental satisfaction (9.3 ± 0.7). Multivariate analysis confirmed that both animated distraction (aOR = 3.9) and the combined approach (aOR = 7.8) were independent predictors of lower pain scores. No serious adverse events were reported.
Conclusion: Combining animated distraction with topical anesthesia significantly improves pain control, behavioral cooperation, and parental satisfaction in young children undergoing IV cannulation. This multimodal strategy is safe, effective, and practical for routine pediatric use.
