Distraction as a technique to control pain in pediatric patients during venipuncture. A narrative review of literature.

INTRODUCTION Distraction is a non-pharmacological intervention aimed to reduce procedural pain in children. Venipuncture is one of the most widely used diagnostic and therapeutic procedure in pediatric patients. Analgesia during venipuncture may be efficiently achieved with distracting techniques. OBJECTIVE To describe active and passive distraction techniques to reduce distress in children undergoing venipuncture. METHOD Data from CINHAL, PubMed, ILISI and Cochrane's databases were used to review existing literature and primary and secondary studies published between 2003 and 2014 were included. Queries were obtained with keywords such as distraction, complementary therapies, pain, pediatric, the Boolean operators AND and OR were used. RESULT Twenty eligible articles out of the one hundred and forty-three retrieved (20/143) were selected; among these there were 3 systematic and 5 narrative reviews, 11 experimental and quasi-experimental studies and 1 observational study. Active and passive distraction techniques seemed extremely effective to reduce distress and pain in children undergoing venipuncture. Modest evidence of efficacy and absent side effects support this approach. CONCLUSION Further RCTs are needed to compare the different types of existing active and passive distraction techniques. The presence of parents and the location where painful procedures are administered should be included in the assessment of this approach.