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Background & Objective: Illness, hospitalization and pain are often first crisis children faced with in their early life. Performing painful procedures such as IV injections for medical purposes are inevitable and stressful events in pediatric wards. Distraction is an inexpensive, practical, and nonpharmacological nursing intervention for pain relief. This study aimed to determine the effects of distraction on some physiological indices (heart rate and O₂ saturation (and intensity of pain in the hospitalized children aged 3-6 years undergoing IV injection.

Methods & Materials: In this clinical trial, 72 children aged 3-6 years who were undergoing IV insertion were recruited for the study. The participants were randomly allocated into two groups of intervention and control. Distraction technique was applied using bubble-maker in the intervention group. After 10 minutes, pain intensity was measured using OUCHER scale. Moreover, heart rate and blood oxygen saturation were measured for three minutes in both groups using Pulse Oxymeter pre- and post-intervention.

Results: The findings showed statistically significant differences in the average heart rate (P<0.01) and the amount of saturated oxygen (P<0.009) and the pain intensity (P<0.001) between two groups after the intervention. The pain decreased significantly in the intervention group in comparison with the control group.

Conclusion: According to the research findings, distraction with bubble-maker resulted in decreasing the physiological responses and intensity of pain in children aged 3- 6 years. This method can be useful in reliving the pain in preschool children undergoing IV insertion.

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Background & Aim: Sedation after coronary artery bypass graft surgery can prevent the side effects of the treatment. The purpose of this study was to determine the effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery.
Methods & Materials: In a single blind randomized clinical trial (IRCT2017050517693N2) from June to August 2017, a convenience sample of 80 patients after coronary artery bypass graft surgery, hospitalized in the intensive care unit of Heshamat Center, Rasht, were selected and randomly allocated into two groups (each group=40). Sedative drug dose was determined using the Richmond agitation sedation scale in the intervention group and determined routinely (based on hemodynamic changes) in the control group. Pain as a confounding variable was evaluated using CPOT tool. Data were analyzed by descriptive statistics and Chi-square, Mann-Whitney, independent t-test and repeated measures ANOVA using the SPSS software version 22.
Results: The mean age of samples was 59.89±7.53 and 66.7% of them were male. There was a significant difference between two groups in the duration of mechanical ventilation (P<0.04), the changes of patients’ blood pressure (P<0.05), need for a vasopressor drug (P<0.05) until extubation and need for the first administration of sedatives (P<0.001).
Conclusion: Utilizing the Richmond tool can reduce the patient’s dependence on ventilator and changes in arterial pressure. Also, using this tool can prevent unnecessary and early administration of sedative and vasopressor drugs in patients.