This systematic review and meta-analysis examined the effectiveness of the Buzzy device combining cold and vibration for needle-related procedural pain in children.
Databases search was conducted from inception to December 2017 to identify randomized controlled trials using the Buzzy device for pain management in children undergoing needle-related procedures. Selection of studies, data extraction, and assessment of risk of bias and quality of evidence were independently performed by 2 reviewers. Quantitative and qualitative analyses were conducted.
A total of 9 studies involving 1138 participants aged between 3 and 18 years old were included in the systematic review and 7 were suitable for meta-analysis. The meta-analysis compared the Buzzy device with a no-treatment comparator and the effect of the device was significant in reducing self-report procedural pain (standardized mean difference [SMD]: −1.11; 95% confidence interval [CI]: −1.52 to −0.70; P<0.0001), parent-reported procedural pain (SMD: −0.94; 95% CI: −1.62 to −0.27; P=0.006), observer-report procedural pain (SMD: −1.19; 95% CI: −1.90 to −0.47; P=0.001), observer-reported procedural anxiety (SMD −1.37; 95% CI: −1.77 to −0.96; P<0.00001), and parent-reported procedural anxiety (SMD −1.36; 95% CI: −2.11 to −0.61; P=0.0004). There was no significant difference for the success of the procedure at first attempt and the occurrence of adverse events.
The Buzzy device seems to be a promising intervention for procedural pain management in children. However, the comparative effect is uncertain due to the presence of significant heterogeneity and very low-quality evidence. There is a need to improve the methodological quality and rigor in the design of future trials to conclude to the efficacy of the Buzzy device.
*Faculty of Nursing
‡Faculty of Medicine, University of Montreal
†CHU Sainte-Justine Research Centre
§Department of Pediatrics, Division of Emergency Medicine, CHU Sainte-Justine, Montreal, QC, Canada
None of the authors is affiliated with the MMJ Lab (Atlanta, GE, USA) that developed the Buzzy device. The review was conducted independently from the lab and is solely for scientific purposes and not a commercial promotion of the device. No funding was received to conduct this research.
A.B. is supported by the Fonds de Recherche du Québec-Santé (FRQ-S), the Ministère de l’Éducation et de l’Enseignement supérieur du Québec (MEES), and the Quebec Nursing Research Network (QNRN). A.B., C.K., and S.L.M. are members of Pain in Child Health (PICH) a strategic training research initiative from the Canadian Institutes of Health Research (CIHR). A.B. is the principal investigator of a study currently being conducted on the efficacy of the Buzzy device. The authors declare no conflict of interest.
Reprints: Ariane Ballard, RN, PhD(c), Faculty of Nursing, Université de Montréal, P.O. Box 6128, Succursale Centre-Ville, Montreal, QC, Canada H3C 3J7 (e-mails: email@example.com; firstname.lastname@example.org).
Received June 29, 2018
Received in revised form January 22, 2019
Accepted January 23, 2019