Paediatr Anaesth. 2025 Nov 27. doi: 10.1111/pan.70094. Online ahead of print.
ABSTRACT
BACKGROUND: Needle-related procedures are among the most frequent and distressing experiences for children. The Buzzy device, which combines cold and vibration, has emerged as one of the best non-pharmacological tools to reduce procedural pain and anxiety. However, its effectiveness may vary substantially across age groups, a factor not consistently addressed in prior literature. This stands in sharp contrast to pain assessment, where age-specific tools are routinely applied, while comparable rigor is lacking for non-pharmacological interventions.
METHODS: We conducted a Bayesian reanalysis of the most recent systematic review and meta-analysis on the Buzzy device in pediatrics, including sixteen randomized controlled trials reporting pain outcomes and six reporting anxiety outcomes. Bayesian hierarchical random-effects models were applied, and study-level covariates were examined through meta-regression. Posterior distributions, credible intervals (CrIs), and Bayes factors (BFs) served to quantify the strength of evidence.
RESULTS: Buzzy significantly reduces pain (SMD -1.05, 95% CrI -1.41 to -0.70) and anxiety (SMD -1.59, 95% CrI -2.65 to -0.54). Age emerged as a significant moderator of pain reduction: children aged 7 years or older showed stronger benefit (posterior probability = 97.9%; BF = 13.9). In contrast, no meaningful associations were observed with sex distribution, procedure type, or risk of bias. For anxiety, the age effect was inconclusive, reflecting limited study numbers and wide credible intervals.
CONCLUSION: This Bayesian reanalysis confirms the effectiveness of Buzzy for pediatric procedural pain while highlighting age as a key determinant. The device appears more beneficial in children aged 7 years or older, supporting its preferential use in school-aged populations, where the greatest clinical benefit is observed.
PMID:41307283 | DOI:10.1111/pan.70094
