Background Venipuncture pain in children results from several factors, which amplify the nociceptive stimulus; among them anticipatory anxiety plays an important role. Children with a chronic disease undergo invasive procedures and venipunture more frequently than other children.
Goal To evaluate whether a difference exists in pain threshold between children with a chronic disease and children with no previous experience of procedural pain.
Methods Cross-sectional analytical trial. A group of children with a chronic disease (group A) and a group of children with no previous experience of venipuncture (group B) aged 4 to 12 were observed during a standardized venipuncture for blood sample drawing. Pain was self-rated with a 1–10 Wong faces scale or a 1–10 numeric scale. Behavioural distress was measured with the Observational Behaviour Distress Scale (OBDS, 1–33).
Results 230 children were examined, 82 in group A and 148 in group B. With regards to pain, children in group A reported a mean pain score of 8.6 (sd 1.2) while children in group B had a mean score of 3.1 (sd 2.4), Anova p=0.00001. With regards to behavioural distress, children in group A had a mean score of 26.7 (sd 4.3) vs. 8.3 in group B (sd 8.4), Anova p=0.00001. The groups did not show statistically significant differences in age and sex distribution.
Discussion Children with a chronic disease, who previously underwent numerous venipunctures, experience a more intense pain and distress than their peers at their first experience of venipuncture.