Effectiveness of Buzzy® for pain relief in children during intramuscular injections: Systematic review and meta-analysis

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BACKGROUND: Intramuscular injections are among the most common and painful procedures in childhood, often associated with stress, fear, and anxiety. The Buzzy® device, which combines vibration and cold, has been proposed as a non-pharmacological strategy to reduce pain during needle-related procedures. OBJECTIVE: This systematic review and meta-analysis evaluated the effectiveness of Buzzy® in reducing pain, fear, and anxiety in children undergoing intramuscular injections. METHODS: We searched seven electronic databases and clinical trial registries (January 2015-December 2024) for randomized controlled trials including children (0-18 years) receiving intramuscular injections with Buzzy®. Standardized mean differences with 95% confidence intervals were calculated using random-effects models. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence with GRADE. The review followed the Cochrane Handbook for Systematic Reviews and the PRISMA guidelines. RESULTS: Twelve studies with 1,333 children were included. Buzzy® significantly reduced self-reported, parent-reported, and observer-reported pain compared to control groups. It also demonstrated benefits in lowering fear and anxiety, although evidence for these outcomes was less consistent. The certainty of evidence ranged from moderate (self- and observer-reported pain) to low (parent-reported pain, fear, anxiety). CONCLUSION: Buzzy® is an effective, reusable, and low-resource intervention to reduce children's pain during intramuscular injections. Future high-quality multicenter randomized controlled trials are needed to confirm its effectiveness for fear and anxiety outcomes. PRACTICAL IMPLICATIONS: Buzzy® can be integrated into routine pediatric care to reduce pain during injections. Its low cost and reusability make it suitable for both high- and low-resource settings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.