Objective: This systematic review and meta-analysis examined the effectiveness of the Buzzy device combining cold and vibration for needle-related procedural pain in children.
Materials and methods: 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.
Results: 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.
Discussion: 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.