Leap Motion Controller for Pain During Venipuncture in Pediatrics
Condition: Procedural Pain; Venipuncture
MeSH terms: Pain, Procedural
Study type: Interventional

Summary: 
      Venipuncture is the most frequent invasive procedure in hospitals and clinics. In the
      pediatric population this is very often associated with fear, anxiety, distress and enhanced
      perception of pain. Local anesthetic creams (like EMLA) are used to reduce pain and distress
      but they need 30-60 minutes of waiting between the application and the puncture, which is too
      much time for most of everyday life clinical contests. Many distraction techniques have been
      studied, both active (ie video games, virtual reality) and passive (ie listening to music,
      visual stimulation).

      Active production of music is one of the most complex activities for our central nervous
      system. It requires a precise timing of a lot of well-coordinated actions, like recognition
      and conservation of a rhythmic structure, precise execution of quick and complex fine
      movements, and with an important involvement of intense emotional experience. It stimulates
      bilaterally primary and secondary auditory cerebral areas, but also motor and premotor areas,
      language areas and their contralateral, cognitive areas. At the same time, it activates
      reward and gratification circuits with stimulation of the limbic system and endorphin release
      and also neurovegetative system. Music is probably the most immediate and spontaneous
      communication tool that can also act at subcortical level without the person being aware of
      what they are receiving and transmitting. Music activates the dopaminergic mesolimbic system,
      which regulates memory, attention, executive functions, motivation and also mood and pleasure
      through the nucleus accumbens. It also produces measurable cardiovascular and endocrine
      responses indicated by reduced serum cortisol levels and inhibition of cardiovascular stress
      reactions.

      The Leap Motion Controller is an infrared device that digitalizes the movements of the hand
      above it in real-time: this is connected with a software that converts this signal into a
      musical tone specifically set. The melody is created very easily just by moving the hand
      above it. With this device, children will be able to produce music without anything
      interposing between them and the sound production. This will allow the patient to focus only
      on the melodies, without technical difficulties that could derive for instance from a visual
      interface or an instrument you have to hold.
    


Intervention name(s): Leap Motion Controller; Traditional distraction techniques
Intervention type(s): Device; Other
Intervention description(s): The Leap Motion Controller is an infrared device that digitalizes in real-time the movements of the hand above it. This signal will be converted into Musical Instrument Digital Interface (MIDI) and then translated into a sound of a pitch that depends on the distance between the hand and the device. The software is set to produce a pentatonic scale, so every melody created by the patient will sound consonant, and the timbre will be warm, calm and in human vocal range (similar to a cello). The operator will do an example, playing a melody, and will invite the patient to imitate him. When the patient gains confidence with the device, after a limited time lapse (from 30 seconds to 3 minutes), while they are playing it with one hand, the venipuncture is done on the other arm; Common distraction techniques will be used (i.e., visual stimulation, lecture)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Procedural Pain; Venipuncture; Children, Distraction