Efficacy of Topical Anesthetic Cream, Cold Angiocath, and Their Combination on Pain and Fear During Pediatric Oncology Venipuncture: A Double-Blind Randomized Controlled Trial

Background: Venipuncture-induced pain and anxiety are major challenges in pediatric oncology. This study evaluated the effects of Xylap cream, cold angiocath, and their combination on pain and fear during venipuncture in children with cancer. Methods: This randomized controlled trial included ۸۷ children undergoing outpatient chemotherapy in Mashhad, Iran. Participants were randomized into four groups: control (routine care), cold angiocath, Xylap cream, and combination. Pain intensity and fear were assessed using FLACC and Children’s Fear Scale (CFS), respectively, across four venipuncture sessions (one baseline, three intervention). Results: The combination group showed the greatest reduction in mean pain (−۴.۴۰, ۹۵% CI: −۵.۰۴ to −۳.۷۵) and fear scores (−۱.۳۹, ۹۵% CI: −۱.۷۵ to −۱.۰۳) compared with control (p < ۰.۰۰۱). Xylap cream alone also significantly reduced pain (−۳.۵۲, ۹۵% CI: −۴.۱۵ to −۲.۹۰) and fear (−۰.۹۶, ۹۵% CI: −۱.۳۴ to −۰.۵۸, p < ۰.۰۰۱). Cold angiocath yielded smaller but significant reductions in pain (−۱.۶۲, ۹۵% CI: −۲.۲۶ to −۰.۹۸) and fear (−۰.۸۷, ۹۵% CI: −۱.۲۴ to −۰.۴۹, p < ۰.۰۰۱). Conclusion: Xylap cream and cold angiocatheter application, alone or combined, effectively reduce venipuncture-related pain and fear in young children with cancer. The combination strategy provided the most substantial benefit for outpatient oncology care.

کلیدواژه ها:

Pediatric Oncology ، Venipuncture ، Pain ، Fear ، Anesthetics ، Local ، Cold Angiocatheter