Gender Variation In Pain Perception After Intravenous Cannulation In Adults

Abstract

Intravenous cannulation is the most frequently used procedures in the wards, casualty and in preoperative preparation. It is a very painful and stressful procedure, thus emotions may become exaggerated at times, triggering vasovagal reaction. Patient’s anxiety and fears concerning needles are real and may even prevent them from seeking health care.Our Aim was to estimate the level of pain perception after intravenous cannulation using Visual analogue pain scale among adult males and females and to study the gender variation in perception of pain.The study was conducted after ethical clearance, with a total of 100 subjects, informed consent was taken. Immediately after the intravenous cannulation using 20 gauge intravenous cannula the subjective pain was assessed by using Visual Analogue pain scale (VAS) on 0 (No pain) – 10 (Max pain). Results thus obtained were analyzed by Pearson Chi Square test(X).Pain perception was moderate to severe (5-10) in 64% of females as compared to 12% in males. There was significant increase in pain perception in females compared to males (X = 31.84, p<.001). BACKGROUND Pain is one of the most common widely under-treated health problems. As a basic scientific definition, pain is a sensation caused by some type of noxious stimulus. From the behavioural aspect, pain is a pattern of responses that function to protect an individual from harm. The International Association for the Study of Pain (IASP) defines pain as “an unpleasant, subjective sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. Untreated and inadequately treated pain causes suffering. Almost every tissue found in the human body contains pain receptors, called nociceptors. It has been estimated that the skin may contain as many as 1,300 nociceptors in one square inch. These nociceptors respond to thermal, chemical, and mechanical stimuli through a-delta, C, and a-beta fibres. The a-delta receptors contain small, myelinated fibres that rapidly transmit acute, sharp pain signals from the peripheral nerves to the spinal cord. C receptors have larger, unmyelinated fibres that transmit pain at a slower rate and are commonly associated with long lasting, burning pain sensation. Intravenous cannulation is the most frequently used procedure in the wards, casualty and in preoperative preparation. It is a very painful and stressful procedure, thus emotions may become exaggerated at times, triggering vasovagal reaction. Patient’s anxiety and fears concerning needles are real and may even prevent them from seeking health care. AIMS & OBJECTIVES To estimate the level of pain perception after intravenous cannulation using Visual analogue pain scale among adult males and females. To study the gender variation in perception of pain. METHODS AND MATERIALS The study was conducted with a total of 100 subjects, after obtaining Ethical clearance and informed consent. The age group included 18 to 50 years of either sex and subjects were taken from general wards and preoperative wards. Immediately after the intravenous cannulation by a trained person, with a single attempt, using 20 gauge IV cannula, the subjective pain was assessed by asking the person to give a score depending on the intensity of pain he/she experienced during cannulationusing Visual Analogue pain scale (VAS) on 0 (No pain) – 10 (Max pain).In case of illiterate patients the Faces of pain scale was used and 05 scale was doubled to match the VAS scores. Gender Variation In Pain Perception After Intravenous Cannulation In Adults 2 of 4 Results thus obtained were analyzed by Pearson Chi Square test (X). Figure 1 The Faces of Pain Scale