Objective To systematically evaluate the efficacy and safety of local anesthesia for venipuncture in children, and to provide evidence for related nursing practice.Methods Web of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Database and VIP databases were searched for randomized controlled trials (RCTs) about the application of local anesthesia in venipuncture in children till June 25th, 2021. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. RevMan 5.3 software was used for meta-analysis.Results A total of 19 RCTs were included, comprising 2 566 patients. All of them were high-quality English articles included in SCI or Medline. The results of meta-analysis showed that: the painless rate [odds ratio (OR)=3.80, 95% confidence interval (CI) (1.88, 7.66), P=0.000 2] and satisfaction rate of venipuncture [OR=2.12, 95%CI (1.27, 3.54), P=0.004] in the local anesthesia group were higher than those in the non-anesthesia group, and the pain score [mean difference=−0.62, 95%CI (−0.77, −0.48), P<0.000 01] in the local anesthesia group was lower than that in the non-anesthesia group. There was no statistically significant difference between the two groups in the success rate of the first puncture [OR=1.14, 95%CI (0.77, 1.68), P=0.52], the incidence of transient skin reactions [OR=1.15, 95%CI (0.67, 1.95), P=0.62], the incidence of paleness [OR=1.11, 95%CI (0.57, 2.15), P=0.76], or the incidence of edema at the puncture site [OR=0.64, 95%CI (0.21, 1.96), P=0.44].Conclusions Local anesthesia can effectively reduce pain and improve the satisfaction of children with venipuncture, and has good clinical safety. It can be used by nursing staff in clinical practice.
JIANG Yunlan, HU Yue, LI Huimin, LI Xue, ZHOU Ling, LI Jianqiong, WANG Huifang, YANG Shuyan, SHEN Yinli, TANG Xin. The application of noninvasive local anesthesia for venipuncture in children: a meta-analysis of randomized controlled trials. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 36(7): 940-948. doi: 10.7507/1002-0179.201911132