Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
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Thermoelectric tourniquet-assisted thermotherapy and cryotherapy for pain, regional blood flow, and satisfaction with intravenous injections among hospitalized patients in Korea: a randomized controlled trial

  • Received : 2024.10.07
  • Accepted : 2024.11.10
  • Published : 2024.11.30
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Abstract

Purpose: Intravenous injections are a common invasive procedure for delivering fluids or medications. Although patients experience pain from needle insertion, this discomfort is often overlooked due to its short duration and perceived insignificance. This study aimed to assess the effect of applying cryotherapy and thermotherapy using a flexible thermoelectric device on relieving the pain caused by intravenous injections. Methods: This randomized controlled trial utilized the modified thermoelectric element (M-TEE) tourniquet, which improves heat and cold transfer through a flexible TEE. Participants were hospitalized adults who had an 18-gauge angiocatheter inserted for surgery. The M-TEE tourniquet was applied 10-12 cm above the injection site, providing thermotherapy (40℃-45℃) or cryotherapy (0℃-10℃) to the respective groups. The control group received no temperature treatment. Pain, peripheral oxygen saturation, pulse rate, and regional blood flow were measured. Post- injection, satisfaction surveys were conducted with participants and practitioners. Results: There was a significant difference in pain perception among the three groups (F = 3.38, p = .041), with the cryotherapy group reporting less pain than the control group (p = .036). Regional venous blood flow significantly increased during thermotherapy (F = 5.99, p = .004), although regional arterial flow remained unchanged. Participant satisfaction differed across groups (F = 3.26, p = .046), with higher satisfaction in the cryotherapy group than in the control group (p = .040). Nurses' satisfaction also varied significantly (F = 24.14, p < .001) across the groups. Conclusion: The M-TEE tourniquet effectively reduces intravenous injection pain and increases patient and practitioner satisfaction, particularly with cryotherapy.

Keywords

Acknowledgement

This manuscript is based on a part of the first author's doctoral thesis from Eulji University.

References

  1. Jacobson AF, Winslow EH. Variables influencing intravenous catheter insertion difficulty and failure: an analysis of 339 intravenous catheter insertions. Heart & Lung. 2005;34(5):345-359. https://doi.org/10.1016/j.hrtlng.2005.04.002
  2. Heinrichs J, Fritze Z, Vandermeer B, Klassen T, Curtis S. Ultrasonographically guided peripheral intravenous cannulation of children and adults: a systematic review and meta-analysis. Annals of Emergency Medicine. 2013;61(4):444-454. https://doi-org/10.1016/j.annemergmed.2012.11.014
  3. Korkut S, Karadag S, Dogan Z. The effectiveness of local hot and cold applications on peripheral intravenous catheterization: a randomized controlled trial. Journal of PeriAnesthesia Nursing. 2020;35(6):597-602. https://doi.org/10.1016/j.jopan.2020.04.011
  4. Yamada Y, Kitamura M, Inayama E, Kishida M, Kataoka Y, Ikenoue T. Acoustic stimulation for relieving pain during venipuncture: a systematic review and network meta-analysis. BMJ Open. 2023;13(12):e077343. https://doi.org/10.1136/bmjopen-2023-077343
  5. No IS, Kim SY. Assessment of the influence of application time of lidocaine patch on pain intensity after venipuncture. Journal of Korean Academy of Fundamentals of Nursing. 2018;25(4):250-258. https://doi.org/10.7739/jkafn.2018.25.4.250
  6. Min YS, Im JM, Kwon SW. A comparison of effect on pain relief between lidocaine and placebo ointment group for phlebotomy. The Korean Society for Clinical Laboratory Blood Bank. 2013;2013(1):53.
  7. Kim YS, Park HR. Effects of topical anesthetic cream on pain at venipuncture in children. Child Health Nursing Research. 2014;20(3):142-148. http://dx.doi.org/10.4094/chnr.2014.20.3.142
  8. Kortobi L, Belymam H, Chkairi NM, Zamd M, Medkouri G, Gharbi MB, et al. Management of pain at arteriovenous fistula puncture: cryotherapy versus lidocaine/prilocaine. Saudi Journal of Kidney Diseases and Transplantation. 2020;31(3):597-603. https://doi.org/10.4103/1319-2442.289446
  9. Sharma B, Kaur S, Sharma V, Garg RK. Impact of local heat application on peripheral intravenous cannulation among patients. International Research Journal of Multidisciplinary Scope. 2024;5(1):364-371. https://doi.org/10.47857/irjms.2024.v05i01.0224
  10. Cozzi G, Valerio P, Kennedy R. A narrative review with practical advice on how to decrease pain and distress during venepuncture and peripheral intravenous cannulation. Acta Pediatrica. 2021;110(2):423-432. https://doi.org/10.1111/apa.15526
  11. Şahin S, Tokgöz B, Demir G. Effect of lavender aromatherapy on arteriovenous fistula puncture pain and the level of state and trait anxiety in hemodialysis patients: a randomized controlled trial. Pain Management Nursing. 2021;22(4):509-515. https://doi.org/10.1016/j.pmn.2021.01.009
  12. Lee JY, Ryu JH, Seo SH, Han S, Park JW. Virtual reality vs. tablet video for venipuncture education in children: a randomized clinical trial. Plos One. 2024;19(8):e0307488. https://doi.org/10.1371/journal.pone.0307488
  13. Yildirim BG, Gerceker GO. The effect of virtual reality and buzzy on first insertion success, prodedure-related fear, anxiety, and pain in children during intravenous insertion in the pediatric emenrgency unit: a randomized controlled trial. Journal of Emergency Nursing. 2023;49(1):62-74. https://doi.org/10.1016/j.jen.2022.09.018
  14. Kim HD, Joo AR. The study of promoting method for VR contents to reduce pain of child patient - focusing on the case studies of VR contents at home and abroad. The Journal of the Korea Contents Association. 2020;20(6):167-176. https://doi.org/10.5392/JKCA.2020.20.06.167
  15. Lee EO, Choi MA. Pain: theory and interverntions. Seoul: Shinkwangpub; 1993.
  16. Won JS, Yang SH, Kim YJ, Lee JI, Shin MK, Choi JS, et al. Fundamentals of nursing II. Seoul: Hyeonmunsa; 2018.
  17. Tapia González I, Esteve Simó V, Moreno Guzman F, Fulquet Nicolás M, Duarte Gallego V, Saurina Solé A, et al. Thermotherapy: improving the vascular access cannulation procedure. The Journal of Vascular Access. 2019;20(4):386-391. https://doi.org/10.1177/1129729818809013
  18. Kim IS. Effects of the applied heat therapy to pediartic patients at the emergency room on IV need time, the number of IV execution and the primary success rate [master's thesis]. Suwon: Ajou University; 2014.
  19. Song JY, Shon KH, Kim NH. The effect of structured cryotherapy on edema, inflammation and pain in postoperative patients with ankle fractures. Asia Pacific Journal of Multimedia Services Convergent with Art, Humanities and Sociology. 2018;8(11):399-413. https://doi.org/10.35873/AJMAHS.2018.8.11.039
  20. Jang JN, Boo SJ, Bae SJ, Bae SH, Ahn JA. Effects of thermomechanical stimulation Intervention during arteriovenous fistula puncture on hemodialysis patients' pain, anxiety, and stress. Korean Journal of Adult Nursing. 2022;34(2):205-214. https://doi.org/10.7475/kjan.2022.34.2.205
  21. Jeon HS, Moon SE. Thermoelectric element trends. Electronic Communication Trend Analysis. 2015;2:144-153.
  22. Hur MH, Choi HS. Effects of a thermoelectric element band on venipuncture associated pain and anxiety: a randomized controlled trial. Asian Nursing Research. 2021;15(5):337-344. https://doi.org/10.1016/j.anr.2021.12.003
  23. Lee TJ. Effects of thermoelectric element tourniquet on venipuncture pain and stress relief [dissertation]. Uijeongbu: Eulji University; 2022.
  24. Çetin SP, Çevik K. Effects of vibration and cold application on pain and anxiety during intravenous catheterization. Journal of PeriAnesthesia Nursing. 2019;34(4):701-709. https://doi.org/10.1016/j.jopan.2018.12.005
  25. Kim NW. Implementation of blood flow speed detection system using single-gate pulsed doppler system [master's thesis]. Suwon: Ajou University; 2002.
  26. Kim MJ. Wearable ultrasound doppler system for monitoring of hemodynamic change with cardiovascular diseases [master's thesis]. Gimhae: Inje University; 2021.
  27. Cho BJ. Domestic and foreign thermoelectric device research trends. Journal of the Korean Institute of Electrical and Electronic Material Engineers. 2012;25(2):38-47.
  28. Chun HW, Moon SE. Application trends in thermoelectric materials. Electronics and Telecommunications Trends. 2015;30(1):144-153. https://doi.org/10.22648/ETRI.2015.J.300115
  29. de Sousa Salgueiro-Oliveira A, dos Santos Costa PJ, Muniz Braga L, Garcia Nascimento Graveto JM, Silva Oliveira V, Santos Dinis Parreira PM. Health professionals' practices related with tourniquet use during peripheral venipuncture: a scoping review. Revista Latino-Americana de Enfermagem. 2019;27(1):e3125. https://doi.org/10.1590/1518-8345.2743-3125
  30. Yoon SK, Shin YS. Heat application according to nurse's belief on evidence-based practice and behavioral intention elated to research. Journal of Korean Academy of Fundamentals of Nursing. 2016;23(3):264-274. https://doi.org/10.7739/jkafn.2016.23.3.264
  31. Miri A, Roshanzadeh Ma, Masoudi R, Kheiri S, Davoodvand S. Effect of local cold therapy on arterial blood oxygen saturation and temperature changes in patients undergoing surgery. Medical-Surgical Nursing Journal. 2021;10(3):e117344. http://doi.org/10.5812/msnj.117344
  32. Back Y, Lee Y. Optimal time of thermotherapy for reducing pain, anxiety, and side effects in arteriovenous fistula puncture patients: a randomized controlled trial. International Journal of Environmental Research and Public Health. 2020;17(19):7147. https://doi.org/10.3390/ijerph17197147
  33. Yoon SH, Hwang WJ, Choi SJ. Comparrison of topical EMLA cream and 1% lidocaine infiltration for radial arterial cannulation. Journal of Chungnam Medical College. 1995;22(2):517-522.
  34. Shin YS, Kim HJ, An JW, Lee YY. Development of evidence-based nursing practice guidelines for cold application in adult care. Korean Journal of Adult Nursing. 2018;30(3):325-345. https://doi.org/10.7475/kjan.2018.30.3.325
  35. Svensson M, Rosen S, Nilsson U. Local warming to reduce pain on peripheral intravenous cannula insertion: a randomised controlled study. Journal of Advanced Perioperative Care. 2006;2(3):75-79.
  36. Neamah RD, Abd Ali DK. Efficacy of cryotherapy in reducing pain related to arteriovenous fistula puncture in hemodialysis patients: a randomized controlled trial. Remittances Review. 2023;8(4):1809-1821. https://remittancesreview.com/menuscript/index.php/remittances/article/view/803
  37. Sasani A, Rahzani K, Hekmatpou D, Haghverdi F. Comparing the effect of cryotherapy on hugo point and needle insertion site on the pain of arteriovenous fistula cannulation in patient with hemodialysis. Journal of Clinical Care and Skills. 2024;5(2):85-91. http://jccs.yums.ac.ir/article-1-242-en.html