TABLE 2.
Systematic reviews of nonpharmacological interventions
| Reference, number of studies | Quality score | Focus | Main results |
|---|---|---|---|
| Cepeda et al 2006 (16), n=4 | 7 | Music on pain during procedures (intravenous cannulation and vaccination) | One study reported the control group had less pain than the music group, one study found no difference between the music and control group, one study reported that the music group had less pain than the control and the fourth study’s results were not reported. Therefore, there is inconclusive evidence of the effectiveness of music. Adverse events were not reported. |
| Kleiber and Harper 1999 (17), n=10 | 5 | Distraction on pain during medical procedures (ie, IV insertion, LP, BMA, venipuncture, injection, burn treatment, dental procedure) | Reduced self-reported pain compared with control (MES=0.62) that accounted for 35% of the explained variance. Subgroup analysis on children seven years of age or younger explained 60% of the variance in pain scores (MES=0.47). Adverse events were not reported. |
| Richardson et al 2006 (18), n=8 | 6 | Hypnosis in pediatric cancer patients for procedure-related pain (ie, LP, BMA, venipuncture, Infusapost access) | 7/8 studies reported that pain was significantly less in the hypnotized groups compared with control or baseline. Due to methodological limitations the evidence for the efficacy of hypnosis is inconclusive. Adverse events werenot reported. |
| Uman et al 2006 (22), n=28 | 7 | Psychological interventions for needle-related procedural pain (ie, immunizations, venipuncture, LP, IV insertions, BMA, IM injections) | Distraction (SMD=−0.24; 95% CI −0.45 to −0.04) and hypnosis (SMD=−1.47; 95% CI −2.67 to −0.27) significantly reduced self-reported pain compared with control. Combined cognitive-behavioural interventions did not significantly decrease pain. Inconclusive evidence to support other commonly used psychological interventions. Adverse events were not reported. |
BMA Bone marrow aspiration; IM Intramuscular; IV Intravenous; LP Lumbar puncture; MES Mean Effect Size; SMD Standardized Mean Difference