Premedical Procedure Anxiety for Intravenous Cannulation in Hospitalized Children: A Facility-based Cross-sectional Study

Aims and background: Inpatient children may experience varying anxiety regarding intravenous (IV) cannulation. This study assessed preprocedural anxiety and procedural pain levels and determined their correlation. Methods: We conducted an observational cross-sectional study involving 4–10-year-old children. Preprocedural anxiety was assessed by the Venham picture test (VPT) and Raghavendra, Madhuri, and Sujata pictorial scale (RMS-PS) while the revised faces pain scale (FPS-R) evaluated pain perception at the IV cannulation site. We analyzed the data via SPSS version 25. Results: Out of 385 children, the majority (234, 60.8%) were aged 4–7 years, and 57.4% were boys. The 4–7-year-olds had significantly higher anxiety levels (p < 0.001), with no significant difference between the sexes. High to very anxiety was reported in 24.7%, while 13% had average anxiety (VPT), and 49% were somewhat happy (RMS-PS). Children who underwent first-time cannulation had higher median anxiety, and we found no significant difference in comparison to those with prior IV cannulation experience. Preprocedural anxiety significantly correlated with procedural pain (Spearman’s rho: VPT vs FPS: 0.76; RMS vs FPS: 0.66, both p < 0.001), with a stronger correlation in children with no prior IV cannulation experience. Conclusions: Younger children and those experiencing first-time IV cannulation reported higher anxiety, with a significant correlation to procedural pain. Clinical significance: Self-report anxiety assessment tools usage can help pediatric teams identify and implement strategies to alleviate anxiety and create a comfortable atmosphere for inpatient children.