Efficacy of topical anesthetic cream, cold angiocath, and their combination on pain and fear during pediatric oncology venipuncture: A double-blind randomized controlled trial.

PURPOSE: This study aimed to evaluate the efficacy of topical anesthetic cream, cold angiocath, and their combination in reducing pain and fear during venipuncture in young children with cancer.

METHODS

A double-blind, randomized controlled trial was conducted with 87 children aged 2-6 years receiving outpatient chemotherapy in a outpatient chemotherapy department in Mashhad, Iran. Participants were randomized into four groups: control, cold angiocath, Xylap cream, or combination. Pain and fear were assessed at baseline and three intervention sessions using the Face, Legs, Activity, Cry, Consolability (FLACC) scale and the Children's Fear Scale (CFS).

RESULTS

The combination group showed the greatest reductions in pain (-4.40, 95 % CI: -5.04 to -3.75) and fear (-1.39, 95 % CI: -1.75 to -1.03) compared with control (p < 0.001). Xylap cream alone also significantly reduced pain (-3.52, 95 % CI: -4.15 to -2.90, p < 0.001) and fear (-0.96, 95 % CI: -1.34 to -0.58, p < 0.001). Cold angiocath yielded smaller but significant reductions in pain (-1.62, 95 % CI: -2.26 to -0.98) and fear (-0.87, 95 % CI: -1.24 to -0.49, p < 0.001).

CONCLUSIONS

Topical anesthetic cream and cold angiocath, alone or combined, reduced venipuncture pain and fear in young children with cancer. The combination strategy was most effective, supporting its use as a simple, safe, and practical intervention in pediatric oncology care.