The effects of thermotherapy and cryotherapy on pain and fear during intravenous cannulation: a systematic review and meta-analysis

Purpose: Intravenous (IV) cannulation is a common hospital procedure that often causes pain and discomfort, leading to injection-related fear. Therefore, effective strategies for alleviating IV-related pain are necessary. To investigate the impact of thermotherapy and cryotherapy on pain and fear associated with IV cannulation, we reviewed randomized controlled trials. Methods: PubMed, Embase, Cochrane, CINAHL, Research Information Service System, DBpia, NSDL, and the Korean Studies Information Service System were searched for studies available in databases as of December 31, 2024. The study participants were individuals who underwent IV line (angio-needle) insertion. The intervention group received thermotherapy or cryotherapy for pain management, and the comparison group received no treatment or placebo. The outcome variables were pain and fear. Results: Significantly lower pain levels were observed in the thermotherapy and cryotherapy groups compared to the control group. The effect size of thermotherapy was shown by a standardized mean difference (SMD) of -0.68, while the SMD for cryotherapy was -0.93. No significant difference was found between thermotherapy and cryotherapy (p = .430). The effect of thermotherapy and cryotherapy on IV-related fear was also significant (SMD = -1.74; p = .005). Conclusion: This meta-analysis confirms that both thermotherapy and cryotherapy are effective in reducing IV-related pain and fear, with no significant difference between the two approaches. However, thermotherapy may offer additional benefits, such as reducing IV insertion time and improving patient satisfaction. These findings suggest that thermotherapy and cryotherapy are viable non-pharmacological options for IV-related pain and fear management.