Randomized Trial Evaluating the Effectiveness of a Leg Crossing and Muscle Tensing Technique on Decreasing Vasovagal Symptoms Among Pediatric and Young Adult Patients Undergoing Peripheral IV Catheter Insertion

Abstract

Peripheral intravenous (PIV) catheter insertion is a common procedure that can cause vasovagal symptoms. Lower extremity muscle tensing techniques decrease these symptoms in adults. However, there are no studies examining this technique in the pediatric population.

Objective: This study aims to determine whether pediatric patients are able to perform the technique and to determine the effects of this technique on vasovagal symptoms in a pediatric population.

Design, setting, participants: A parallel-group randomized controlled trial was conducted with 28 patients cared for in a pediatric surgery unit.

Intervention: Patients randomized to the experimental group performed the leg crossing and muscle tensing technique during PIV placement. Patients in the control group received standard care during PIV placement.

Primary outcome measure: The primary outcome measure was the frequency of experiencing at least one vasovagal sign or symptom which included nausea, vomiting, dizziness, pallor, sweating/diaphoresis, and fainting.

Results: Patients randomized to perform the technique were able to perform it without difficulty. There was a lower frequency of experiencing vasovagal symptoms among patients in the experimental group (15%) compared to patients in the control group (62.5%) (Fisher's exact test, p=0.02). The number of vasovagal symptoms experienced by patients in the experimental group (M=0.3) was significantly lower than the number of vasovagal symptoms experienced by patients in the control group (M=1.13), t(26)=2.302, p=0.03.

Conclusion: A leg crossing technique is a low cost, low risk, and effective strategy to teach to pediatric patients resulting in reducing vasovagal symptoms.

Keywords: Leg tensing procedure; PIV insertion; Pediatrics; Vasovagal symptoms.