The comparison of using cathodal, anodal direct current stimulation and intermittent with combined analgesia ointment of lidocaine and prilocaine on pain and comfort levels in arterial, vein blood sampling and intramuscular injection processes

This study aims to investigate the effects direct currents and alternating on the pain level caused by venous-arterial blood sampling and intramuscular injections.

A clinical trial with a control group, with parallel groups, double-blind, randomized, phase 3 is conducted on 200 patients.

The statistical population includes patients referred to Imam Reza and Imam Khomeini hospitals, Kermanshah city, diagnosed with respiratory failure and infection, who require arterial, venous blood sampling and intramuscular injection. Patients are randomly divided into 5 groups. The research is conducted in a double-blind manner, so that the researcher recording the data and also the patient do not know the type of intervention and grouping.

Inclusion criteria: full consciousness, reading, writing and verbal abilities, no addiction, not taking sedatives and painkillers during 24 hours, not having a pacemaker and implantable cardiac defibrillators, not having a history of diabetes and vascular diseases. Exclusion criteria: patients with more than 5 sampling attempts, non-cooperation of the patient, bleeding from the sampling site.

Control group; patients receive inactive electrical stimulation and an inactive gelatinous substance. The group receiving anesthetic ointment, 1 gram of anesthetic ointment lidocaine and prilocaine is used. Inactive electrode is also placed. In the direct current group of the anodal and cathodal; the application of anode or cathodal direct current is performed at the same time as the needle tip enters the skin. In the group of alternating electrical current stimulation; High-frequency alternating current is applied at the same time as the needle tip enters the skin of the area until the end of the procedure.

The pain level, comfort level, Heart rate

Randomization of samples in this study is done by computer software. A random sequence of letters A, B, C, D (for the intervention groups) and E (for the control group) is made in blocks with a random number of 6 and 8 letters. Then these obtained blocks are placed in sealed envelopes. Before starting the study, one of the researchers opens one of the envelopes and finally the patient is placed in one of the intervention or control groups.

In the control group, the connection of the electrode to the skin and the needle head is studied, but the device is in inactive mode. Also, a non-effective gelatinous substance (lubricant gel) (similar to the pharmaceutical form of EMLA anesthesia ointment) is used in the control group. In the group receiving anesthetic ointment, anesthetic ointment is placed on the injection or sampling site, and electrodes without electrical stimulation function are also used. Active electrodes of electrical stimulation are used in different groups of electrostimulation devices, but gelatinous substance without effect (lubricant gel) is also used. Therefore, due to the seemingly identical interventions, patients do not know grouping and the type of stimulation interventions. Also, the co-colleague of the variable registration project does not know the type of grouping.

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