Humanoid Robot-Based Distraction to Reduce Pain and Distress During Venipuncture in the Pediatric Emergency Department: A Randomized Clinical Trial

Student Researcher:
Robin Manaloor

Supervisor / Principle Investigator:

Additional Authors:
Shannon Scott
Tanya Beran
Keon Ma
Tim Graham
Hsing Jou
Lisa Hartling
Ben Vandermeer
Leanne Sigismund
Mithra Sivakumar
Natasha Beirnes

MD Class of 2020


Introduction: Intravenous insertion (IVI) is identified by children as extremely painful and the resultant distress can have lasting negative consequences. There is an urgent need to better manage such procedures.

Objective: To compare pain and distress with the addition of humanoid robot-based distraction to standard of care, versus standard of care alone, in children undergoing IVI.

Design/Setting: This two-armed randomized controlled trial (RCT) was operated from April 2017 to May 2018 at the Stollery Children’s Hospital emergency department (ED).

Participants: Children aged 6 to 11 years, requiring IVI were included. Exclusion criteria included hearing or visual impairments, neurocognitive delays, sensory impairment to pain, previous enrollment, and discretion of the ED clinical staff. 426 pediatric patients were screened and 340 were excluded.

Results: We recruited 86 children of which 55% (47/86) were male; 9% (7/82) were premature at birth; 82% (67/82) had a previous ED visit; 30% (25/82) required previous hospitalization; and 78% (64/82) had previous IV placement. A clinical reduction in pain of one face and a statistically significant reduction in distress was observed with the addition of humanoid robot-based distraction to standard care. The Faces Pain Score (FPS-R) during the IV procedure was 4 in the standard care group alone, compared to 2 with the addition of humanoid robot-based distraction (p=0.13). The total distress score during the procedure measured was 1.49±2.36 (standard of care) compared to 0.78±1.32 (robot group) (p=0.047). Parents were also more satisfied with management of their child’s pain in the robot group (95% very satisfied) compared with standard care (72% very satisfied) (p=0.002).

Conclusions: Humanoid robot-based distraction therapy appears to have a positive impact on distress and to a lesser extent, pain, in children undergoing IVI. Further trials need to be completed to confirm utility in other settings and age groups.